abnormal mri brain Cerebritis and Abscess

• —most brain abscesses are bacterial
• — streptococci accounting for the majority
• —haematogenous dissemination, penetrating trauma or direct spread
• — Blood-borne infection can occur anywhere in the brain, but has a predilection for the territory of the middle cerebral arteries
• —fever ,headache and focal neurological deficits. Brain abscesses are multiple in 10–50 per
• stages in the evolution of cerebral abscess.
• —there are four stages
• —1. Acute cerebritis (the first 4 to 5 days).
• In early cerebritis, mild central nodular enhancement may be seen on contrast-enhanced CT or MRI scans
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2. Late cerebritis (at 7 to 10 days). In the late cerebritis stage brain enhancement on CT scans

abnormal mri brain Late cerebritis. A, Gadolinium-enhanced MRI study shows thick, smooth, ringlike enhancement with surrounding edema. B, Gadolinium-enhanced MRI study (coronal view) shows a second small, adjacent ringlike enhancement.

stages in the evolution of cerebral abscess

—3. Early abscess (at 10 to 14 days). Formation of a collagenous capsule by fibroblasts is seen. The central necrotic area is liquefied. Surrounding edema persists.
4. Mature abscess (after 14 days). A decrease in surrounding edema

—gliotic reaction at outer margin of the abscess capsule.

Abscess treated conservatively with antibiotics

• Abscess caused by gas-forming organism
• —The most distinctive feature of abscess on imaging is the presence of a smooth, thin capsule with a moderate amount of cerebral edema.
• — It is located at the corticomedullary junction and usually extends into the white matter.
• —Nonenhanced CT scans show a low-density area with mass effect and compression of the ventricular system.
• — rupture of the abscess into an adjacent ventricle {medially into the ventricular system because the medial wall is thinner than the lateral wall

Abnormal mri brain Abscess

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