Cerebral abscess

Case contributed by Dr Fatima Shire

Presentation

Headache, dizziness and blurred vision.

Patient Data

Age: 50 years
Gender: Male
Modality: CT

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

Modality: MRI

Ring enhancing lesion in the left occipital lobe. Hypointense rim seen on T2 sequence associated with mass effect and surrounding perilesional oedema 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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Case Information

rID: 47618
Case created: 24th Aug 2016
Last edited: 3rd Oct 2016
Inclusion in quiz mode: Included

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