Deep brain abscess
Headache followed by disturbed conscious level. The patient was previously diagnosed with bacterial endocarditis
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Right basal ganglionic well defined cystic lesion that exhibits low signal of its content in T1 and FLAIR and high signal in T2. Its wall displays low signal in T2 and FLAIR while hyperintense signal in T1 likely from free radicals and enhances avidly following contrast injection (ring enhancement). It is surrounded by perifocal edema and exerts positive mass effect upon the adjacent lateral ventricle.
Diagnosis: Intracerebral abscess
DD of lesions with ring enhancing lesions includes brain abscess, metastasis, subacute infarction, lymphoma in immunocompromised patient, glioma, radiation necrosis and demyelination (incomplete ring). The patient underwent surgical drainage and pus was aspirated.