Neuro_MR_Brain: 22 F, pregnant, AMS, seizure.

MRI BRAIN WITHOUT CONTRAST:

CLINICAL HISTORY: 22F h/o STDs, bilateral axillary abscesses who is 8 months pregnant admitted to neurosurgery for management of temporal mass. 1d ago developed acute onset expressive aphasia, AMS and ataxia. Today had grand mal seizure in the morning.

FINDINGS:

Parenchyma: Left temporal mass, measuring 17 x 16 mm, demonstrating central diffusion restriction with marked surrounding vasogenic edema. There is also mild T2/FLAIR signal abnormality in the left thalamus and left hemisphere cortex, particularly in the posterior brain with corresponding elevated cerebral blood flow.

Ventricles and extra-axial spaces: Appropriate for age.

Orbits: Normal.

Visualized paranasal sinuses: Clear.

Mastoid air cells: Clear.

Bones: Normal.

Additional comment: None.

IMPRESSION:

1. 17 x 16 mm left temporal lesion with central diffusion restriction and marked surrounding edema consistent with cerebral abscess, most likely pyogenic in etiology although a tuberculous abscess can also have this appearance.

2. T2/FLAIR signal abnormality in the left thalamus and left hemispheric cortices with gyral swelling and elevated cerebral blood flow; findings are most likely related to seizure activity.

(Pyogenic brain abscess)