Ovoid right occipital lobe white matter lesion measures 14 mm in maximum diameter. The centre of the lesion is low T1 signal, reasonably high T2 signal and intermediate signal on FLAIR. There is a slightly irregular rim with immediate T1 signal and low T2 signal. Surrounding vasogenic oedema extends to the occipital horn of the right lateral ventricle, where there is dependent debris filling the occipital horn with resultant loss of normal CSF signal intensity. Contrast enhancement at the periphery of the lesion anteriorly becomes contiguous with the thickened and enhancing ependymal lining of the right occipital horn and trigone. Diffusion imaging confirms true restricted diffusion in the centre of the lesion as well as the dependent material in the occipital horn. No ventricular dilatation. No significant mass effect or midline shift.
No other focus of signal abnormality is demonstrated. No other pathological contrast enhancement appreciated. Normal flow voids are demonstrated. The dural venous sinuses demonstrate normal contrast opacification.
IMPRESSION
Features in keeping with a right occipital lobe abscess and acute ventriculitis. Neurosurgical team aware of the results.