Presentation
Headache, fever, and altered mental status. Background congenital heart disease.
Patient Data
A well-defined, multi-lobulated large low-attenuating peripherally-enhancing fluid density cystic lesion in the left fronto-parietal region surrounded with significant parenchymal edema causing mass effect over the adjacent brain parenchyma resulting in displacement of midline structures toward the right side.
Another smaller lesion with similar characteristics is noted in the left frontal lobe adjacent to the frontal horn of left lateral ventricle.
The MRI is performed approximately 1 month after the CT.
At least two closely located peripherally enhancing lesions with central diffusion restriction and surrounding marked mass effect and edema in left front parietal lobes.
A few smaller loculi are also seen in the vicinity.
There is a resultant mass effect evident by effacement of the left lateral ventricle and midline shift of about 2.5 cm toward the right side.
Mild dilatation of the right lateral ventricle is noted.
There is evidence of mild meningeal enhancement.
Case Discussion
The features are consistent with cerebral abscess formation in the left cerebral hemisphere.
As the patient also had heart disease, he died before any intervention.
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