Meningitis; extra axial abscess& post infectious leuko encephalitic changes.

Imaging Technique:

The following  pulse sequences for the brain  were obtained  on a high field MRI.

Axial T1 and T2 weighted images

Coronal FLAIR images

Sagittal T2 weighted images

Revealed:

    4x1 cm lentiform shape extra axial llesion show typical appearance of fluid signal intensity with peripheral enhancement accompanied with meningeal enhancement and forming mass effect with focal pressure effect and mid line shift around 8mm.

There is marked increase signal intensity at the RT fronto parietal lobe at corticomedullary level which show scalloping  raising  the suspicion of post infectious leuko encephalopathic changes.

    * Extra axial spaces: Normal in size and morphology

    * Hemorrhage: none   

    * Ventricular system: Normal in size and morphology

    * Basal cisterns: normal

    * Cerebral parenchyma: normal

    * Midline shift: none

    * Cerebellum: normal

    * Brainstem: normal

Other:

    * Calvarium: normal

    * Vascular system: normal

    * Visualized Paranasal sinuses: clear

    * Visualized Orbits: normal

    * Visualized upper cervical spine: normal

    * Sella and skull base: normal

    * Left/right mastoid air cells: normal

Impression:

RT fronto parietal extra axial infected collection .

RT frontal high signal intensity could be due to demyelinating reaction secondary to infection.

Reported By : DR. MOHAMED MOHYELDIN       

                          Consultant Radiologist