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.
Ventricles and extra-axial spaces: Appropriate for age.
Visualized paranasal sinuses: Clear.
Mastoid air cells: Clear.
Additional comment: None.
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.