Cerebral abscess

Case contributed by Dr Ian Bickle

Presentation

Young male patient with headache and a pyrexia. No history of immunosuppressive disease.

Patient Data

Age: 35
Gender: Male
Modality: CT

Enhancing right basal ganglia lesion, with perilesional odema and ventricular displacement.

The lesion is multiloculated.

Modality: MRI

Multifocal thick walled enhancing lesion centred on the right lentiform nucleus, with avid ring enhancement and central diffusion restriction.

Perilesional oedema, which in conjunction with the lesion itself is causing effacement and displacement of the frontal horn of the right lateral and third ventricles.

Image guided surgery

Modality: Photo

Image guided surgical navigation performed - aspiration of the cerebral abscess in progress  - the syringe has a significant volume of pus within.

( Images courtesy of Dr Selvam, Neurosurgeon, RIPAS Hospital, Brunei )

Case Discussion

Ring enhancing cerebral lesions can result from various aetiologies. One cause is a cerebral abscess, which has characteristic imaging appearances (in most cases) on MRI with restricted diffusion on DWI/ADC maps, as well as spectroscopy patterns.

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Case Information

rID: 26111
Case created: 29th Nov 2013
Last edited: 18th May 2016
Inclusion in quiz mode: Included

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