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CB1228

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Case Notes

History

27 yo male with treated ALL, now neutropenic. He presented with fever, and systemic infectious symptoms.

Exam

Prior Study

MR flair
1. There is a single intraaxial, early stage, brain abscess in the mesial aspect of the left occipital lobe.

MR T1-w pre and post contrast axial and post coronal
1. The post contrast features are also consistent with a single intraaxial, early stage, brain abscess in the mesial aspect of the left occipital lobe.

MR diffusion
1. There is no water restriction in the core of the abscess cavity to suggest that the abscess has progressed to the mature phase (>12 days).

Dicom

 
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Section 1

Submit Findings

CB1228

Findings

MR T2-w turbo spin-echo

There is evidence of leptomeningitis.

There is evidence of primary pachymeningitis.

There is evidence of secondary pachymeningitis from extracranial infection site.

There is evidence of cerebritis.

There is evidence of brain abscess(es).

There is evidence of hydrocephalus (ventriculomegaly plus signs of elevated CSF pressure).

There is evidence of ventriculitis and intraventricular infected sequestra.

There are characteristic features for certain infections (i.e. HSV1 & 2, tuberculosis, etc.).

Recognize the features of infection in the immuno-incompetent host (i.e. HIV, AIDS, steroid therapy, transplant patients, chemotherapy).

There is evidence of raised intracranial pressure (i.e. optic hydrops, partially empty sella, and/or downward tonsillar displacement).

No other significant imaging findings are present.