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Cerebral Abscess
Case Detail
| Anatomy: Brain |
 Joseph Junewick, MD FACR |
| Diagnostic Category: Infectious-Inflammatory |
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| Created: over 3 years ago |
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| Updated: over 2 years ago |
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| Tags:
PEDS
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| Modality/Study Types:
MR
CT
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Activities:  PDF  ImageJA |
History
13 year old female with headache and mild constitutional symptoms.
Case Images
Diagnosis
Right cerebral (parietal) abscess.
Findings
CT – Non-contrast axial image demonstrates a large right parietal mass with vasogenic edema.
MRI – Axial T2 image demonstrates a thick walled collection with vasogenic edema; sagittal post-gadolinium T1 image intense rim enhancement (the central border is sharp and the peripheral border is not).
Discussion
Brain abscesses usually occur at the gray-white matter junction. The inner margin of the enhancing capsule is smooth whereas the outer margin is irregular and surrounded by edema. Diffusion is usually restricted. Spectroscopy demonstrates elevated amino acid and lactic acid peaks. Surgical drainage is necessary. Rupture of the abscess into the ventricular system portends a poor outcome.