Late cerebritis

Case contributed by Dr Mariana Sanchez

Presentation

History of dermatomyositis presents with a severe headache. Left pyramidal syndrome and fever are documented on admission.

Patient Data

Age: 60 years
Gender: Male
CT

Contrast CT shows a poorly defined hypodense lesion at the level of the right thalamus that results in compression of adjacent structures with slight perilesional oedema and does not show enhancement.

MRI

MRI shows a rounded intra-axial lesion, hypointense in T1 with no evidence of blood, corroborated on echo gradient. FLAIR sequence demonstrates oedema and at the ipsilateral mesencephalic level. In DWI and ADC there is a restriction in the central portion of the lesion and with the application of contrast medium a fine annular enhancement is observed.

Case Discussion


Blood cultures confirmed infection with listeria. These features are consistent with late cerebritis early abscess formation with central liquefaction and surrounding enhancing capsule formation. 

 

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Case information

rID: 54948
Case created: 9th Aug 2017
Last edited: 11th Sep 2017
Inclusion in quiz mode: Included
Institution: instituto nacional de ciencias medicas y Nutrición Salvador Zubirán

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