Demographics:
46 years old, Male
Indication:
Headache, dizziness
Findings
- Hypoattenuating lesion in the superior left cerebellar hemisphere measuring 2.1 x 2 x 2.3 cm with a thin hyperattenuating rim and surrounding hypoattenuation likely representing edema
- Associated mass effect with local sulcal effacement, rightward deviation of the vermis, and partial effacement of the fourth ventricle
- Left middle ear and mastoid opacification with loss of many of the expected mastoid air cell septae
Diagnosis
Brain abscess
Coalescent mastoiditis
Sample Report
Hypoattenuating lesion in the superior left cerebellar hemisphere measuring 2.1 x 2 x 2.3 cm with a thin hyperattenuating rim, which is concerning for abscess or neoplasm. Recommend neurosurgical consultation as well as brain MRI with and without contrast for further evaluation.
Surrounding edema resulting in local sulcal effacement, rightward deviation of the vermis, and partial effacement of the fourth ventricle.
No acute hemorrhage or hydrocephalus.
Left middle ear and mastoid opacification with loss of many of the expected mastoid air cell septae concerning for coalescent otomastoiditis. Recommend ENT consultation.
Discussion