Cerebellar abscess secondary to mastoiditis

Case contributed by Dr Ian Bickle

Presentation

Young adult with learning difficulties presents moribund with a fever.

Patient Data

Age: 25 years
Gender: Male
Modality: CT

Huge ring enhancing cystic lesion with perilesional oedema in the left cerebellar hemisphere, which is displacing and effacing the 4th ventricular with a resultant triventricular hydrocephalus.

The cerebellar tonsils herniate inferiorly due to mass effect.

Modality: CT

The left mastoid air cell are opacified as is the middle ear with partial destruction of the ossicular chain.

The petrous temporal bone contains a mixture of lucent and sclerotic with destruction of the medial cortex close to the petrous apex.

Case Discussion

Extreme example of two pathologies.  A profound mastoiditis with intraventricular extension, causing a huge cerebellar abscess, with a resultant hydrocephalus.

The patient went to surgery immediately, with no residual neurological deficit after surgery.

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Case Information

rID: 26284
Case created: 11th Dec 2013
Last edited: 5th Mar 2016
Inclusion in quiz mode: Included

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