MRI BRAIN - with contrast and MRV
4 cm midline occipital cystic lesion which communicates through a smooth defect of 9 mm in the occipital bone. This directly communicates with thick irregular enhancing soft tissue surrounding and involving the posterior aspect of the sagittal sinus.
Several small sub-centimetre nodules along the course of the sagittal sinus. No flow in the mid and posterior aspects of the sagittal sinus.
2.4 cm rim enhancing cystic right occipital lobe lesion with avid internal restriction.
Intense, near symmetrical vasogenic oedema in both parieto-occipital regions.
No hydrocephalus.
Infratentorial brain normal in appearance.
Comment:
1. Right occipital lobe cerebral abscess
2. Dural centred solid-cystic lesions - these appear most likely infectious-inflammatory in nature. Tuberculosis would be the first consideration.
3. Sagittal sinus occlusion with resultant cerebral oedema.