Presentation
Fits, fever
Patient Data
Age: 90 years
Gender: Female
From the case:
Brain abscess with ventriculitis
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- bilobed oval lesion at the upper right frontal lobe, with hyperdense rim and central hypodensity
- layering material within occipital horn right lateral ventricle, on background of ventriculomegaly
- extensive cystic change along bilateral temporal lobes and frontal lobes, as well as diffuse hypodensity of the periventricular white matter
Findings suspicious for right frontal lobe cerebral abscess, likely ventriculitis
From the case:
Brain abscess with ventriculitis
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- oval T1 hypointense, T2 hyperintense lesion centered within right superior frontal gyrus. Diffusion-weighted images show central restriction
- T1/T2 isointense material layering within occipital horn and atrium of right lateral ventricle, which also exhibits diffusion-restriction
- background of bilateral cystic encephalomalacia and nonspecific T2 hyperintensity throughout most of the periventricular white matter
- ventriculomegaly
These findings remain consistent with right frontal lobe cerebral abscess and ventriculitis.
Case Discussion
Classic findings of cerebral abscess.
Diffusion-restricting layering material within the ventricle, often within the occipital horn lateral ventricle, is consistent with empyema, indicating ventriculitis.