Cerebral abscess

Case contributed by Fatima Shire
Diagnosis certain

Presentation

Headache, dizziness and blurred vision.

Patient Data

Age: 50 years
Gender: Male
ct

Ring enhancing lesion in the left occipital lobe with significant surrounding peri-lesional edema

mri

Ring enhancing lesion in the left occipital lobe. Hypointense rim seen on T2 sequence associated with mass effect and surrounding perilesional edema causing no significant midline shift. On diffusion imaging there is evidence of restriction noted predominantly in the periphery of the lesion.  No other similar lesions seen.

Case Discussion

The patient had left occipital craniotomy and drainage of brain abscess. The culture of the removed abscess has revealed Streptococcus sensitive to ceftriaxone. The patient recovered well and has no neurological deficits.

A complete thin ring of T2 signal loss is a helpful sign in cerebral abscesses and tends not to be seen in the main differentials (i.e. cerebral metastases). 

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