EURORAD ESR

Case 9174

Ventriculitis as a complication of a brain abscess

Author(s)
Soria N, Granell Moreno E, Nuñez Marin F
 
Patient
male, 81 year(s)
 
 
  • Figure 1
    Contrast-enhanced head CT

    Contrast-enhanced head CT images show a low density mass in the frontal lobe with peripheral oedema and a thin ring-enhancement after contrast medium injection. Note hyperdense material on the right occipital horn...

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT; Procedure: Education; Special Focus: Abscess;
     
     
  • Figure 2
    Brain abscess with associated ventriculitis

    T2-weighted images show a hypointense rim associated to hyperintense foci opened into the right frontal horn.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Special Focus: Abscess;
     
     
  • Figure 3
    Frontal brain abscess ruptured to ventricular system

    T1-weighted images after gadolinium injection show a ring-enhancement corresponding to the capsule of the abscess. There is a mild ependymal enhacement in the right occipital horn (white arrow).

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Special Focus: Abscess;
     
     
  • Figure 4
    Brain abscess with ventriculitis

    Sagittal T1-weighted image after gadolinium injection demonstrates the rupture of the abscess into the right lateral ventricle.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Special Focus: Abscess;
     
     
  • Figure 5
    Brain abscess with ventriculitis

    FLAIR images show an ependymal hyperintensity on the right occipital horn (white arrow).

     
     
     
  • Figure 6
    Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) imaging.

    Both the lesion (black arrow) and the material inside the left occipital horn (white arrow) show high signal intensity on diffusion-weighted imaging (DWI) and reduced apparent diffusion coefficient (ADC).(Black arrow)

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR-Diffusion/Perfusion; Special Focus: Abscess;
     
     
  • Figure 7
    MR spectroscopy

    MR spectroscopy (MRS) shows high levels of lactate, acetate, lipids and amino acids.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR-Spectroscopy; Special Focus: Abscess;
     
     
Contrast-enhanced head CT images show a low density mass in the frontal lobe with peripheral oedema and a thin ring-enhancement after contrast medium injection. Note hyperdense material on the right occipital horn (arrow).
 
T2-weighted images show a hypointense rim associated to hyperintense foci opened into the right frontal horn.
 
T1-weighted images after gadolinium injection show a ring-enhancement corresponding to the capsule of the abscess. There is a mild ependymal enhacement in the right occipital horn (white arrow).
 
Sagittal T1-weighted image after gadolinium injection demonstrates the rupture of the abscess into the right lateral ventricle.
 
FLAIR images show an ependymal hyperintensity on the right occipital horn (white arrow).
 
Both the lesion (black arrow) and the material inside the left occipital horn (white arrow) show high signal intensity on diffusion-weighted imaging (DWI) and reduced apparent diffusion coefficient (ADC).(Black arrow)
 
MR spectroscopy (MRS) shows high levels of lactate, acetate, lipids and amino acids.
 
 
 
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