Cerebellar abscess (MR spectroscopy)

Case contributed by Dr Muneesh Sharma

Presentation

Recent onset headaches and vomiting, febrile

Patient Data

Age: 45 years
Gender: Male

A well-defined rim enhancing irregular cystic lesion in the superior right cerebellar hemisphere with perilesional edema and mass effect on the fourth ventricle and brainstem. Marginal hemorrhage is noted no solid component seen.

MR spectroscopy shows no choline / NAA in the margins. Massive lipid and amino acid peaks are seen at 1.2 and 0.8.

Diffusion restriction is present.

Case Discussion

Features are consistent with a cerebellar abscess.

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