Brain Abscesses with Ventriculitis

Findings:

Multiple ring enhancing lesions are associated with surrounding vasogenic edema, with central cores of restricted diffusion which also involves the left lateral ventricle with a fluid fluid level. The rim enhancing lesions within the right parietal subcortical region and left deep parietal periventricular region demonstrate T2 hypointense and faintly T1 hyperintense rims.

Differential Diagnosis/Discussion:

The differential diagnosis of multiple ring enhancing intraaxial lesions primarily includes metastatic disease and infection. Multiple incomplete ring enhancing lesions may be seen with active multiple sclerosis, and other types of demyelinating processes can have peripheral enhancement, but not typical to be complete rim enhancement. In this case, a helpful differential diagnostic feature is the presence of restricted diffusion both in the central core of the lesions and within the ventricular system, which indicates infection.

BACK TO MAIN PAGE