Otogenic cerebral abscess
15 year-old girl with diplopia, headache. No fever. Had recent surgery on the left middle ear.
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A sharply demarcated oval mass in left temporal and parietal lobes, with hypo-intense content and slight hyperintense rim, with considerable mass effect on the brainstem. On FLAIR it is of mixed content, thin hypointense rim, surrounding oedema and mass-effect, hyperintense signal in left petrous bone. Following administration of contrast, there is rim enhancement of the lesion and continuity with enhancing area in left middle ear. The content demonstrates profound diffusion restriction.