Cerebral abscess post cardiac surgery

Case contributed by Ahmed Abdrabou
Diagnosis almost certain

Presentation

Confusion and disturbed conscious level after surgical correction of tetralogy of Fallot

Patient Data

Age: 9 years
Gender: Male

Left temporal intra axial cystic space occupying lesion surrounded by moderate perifocal edema. It has thick capsule that displays low signal in T2, bright signal in T1 and avidly enhancing post contrast. The cyst content shows diffusion restriction being bright signal in DWI and low signal in ADC.

Diagnosis: left temporal lobe abscess

Case Discussion

The early stage of abscess displays typical diffusion restriction. Its capsule usually displays low signal in T2 WI and enhances with contrast. Cardiac patients have an increased risk of developing a cerebral abscess.

MR spectroscopy may be performed in the diagnosis of a cerebral abscess.

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