There is a well-defined left frontal lobe intra-axial space occupying lesion with associated edema and subsequent mass effect in the form of compression of the ipsilateral frontal horn of the lateral ventricle and shift of the midline toward the right side.
The center of the left frontal lobe lesion displays high signal intensity (SI) on T2, intermediate SI on FLAIR and low SI on T1 as well as high SI on DWI with corresponding low ADC map denoting restricted diffusion. The periphery of the lesion is of low SI on T2 and post-contrast ring enhancement. Perfusion images show that the lesion and associated edema are hypoperfused. The posterior wall of the lesion shows a focal defect with a focal cerebral enhancing nodule. The findings are keeping with cerebral abscess.
Fronto-parietal pachymeningeal thickening and enhancement as well as extra-axial collections with marginal enhancement and restricted diffusion are seen in keeping with extra-axial empyema. The superior sagittal sinus is attenuated.
There is mucosal thickening and enhancement of the anterior ethmoidal and frontal paranasal sinuses. Milder mucosal thickening is seen involving both maxillary sinuses.
There is abnormal post-contrast enhancement of the frontal bone.
Significant soft tissue thickening, hyperperfusion and post-contrast enhancement are seen involving the nose, forehead and scalp with multiple subgaleal collections with marginal enhancement and restricted diffusion in keeping with multiple abscesses.