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Brain Abscess Masquerading as Brain Infarction
Occasionally, acute ischemic stroke can be difficult to differentiate from acute intracranial infection. We describe a patient who presented with sudden onset of right hemiparesis and fever. Magnetic resonance imaging (MRI) was consistent with an acute stroke, showing multiple lesions with restricte...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408080/ https://www.ncbi.nlm.nih.gov/pubmed/32664484 http://dx.doi.org/10.3390/brainsci10070440 |
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author | Jeong, Da-Eun Lee, Jun |
author_facet | Jeong, Da-Eun Lee, Jun |
author_sort | Jeong, Da-Eun |
collection | PubMed |
description | Occasionally, acute ischemic stroke can be difficult to differentiate from acute intracranial infection. We describe a patient who presented with sudden onset of right hemiparesis and fever. Magnetic resonance imaging (MRI) was consistent with an acute stroke, showing multiple lesions with restricted diffusion in the left middle cerebral artery territory. These lesions were not enhancing and were not associated with vasogenic edema. A diagnosis of acute stroke was made based on the clinical and radiographic data. Follow-up MRI obtained eleven days later showed interval development of ring enhancement and vasogenic edema surrounding the previously noted core of restricted diffusion. Based on these findings, the diagnosis was revised to cerebral abscesses and the patient was treated successfully with antibiotics. In retrospect, the largest diffusion-weighted lesion on baseline MRI demonstrated two characteristics that were atypical for stroke: it had an ovoid shape and a subtle T2 hypointense core. This case demonstrates that acute clinical and radiographic presentation of cerebral abscess and ischemic stroke can be strikingly similar. Follow-up imaging can be instrumental in arriving at an accurate diagnosis. |
format | Online Article Text |
id | pubmed-7408080 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-74080802020-08-25 Brain Abscess Masquerading as Brain Infarction Jeong, Da-Eun Lee, Jun Brain Sci Case Report Occasionally, acute ischemic stroke can be difficult to differentiate from acute intracranial infection. We describe a patient who presented with sudden onset of right hemiparesis and fever. Magnetic resonance imaging (MRI) was consistent with an acute stroke, showing multiple lesions with restricted diffusion in the left middle cerebral artery territory. These lesions were not enhancing and were not associated with vasogenic edema. A diagnosis of acute stroke was made based on the clinical and radiographic data. Follow-up MRI obtained eleven days later showed interval development of ring enhancement and vasogenic edema surrounding the previously noted core of restricted diffusion. Based on these findings, the diagnosis was revised to cerebral abscesses and the patient was treated successfully with antibiotics. In retrospect, the largest diffusion-weighted lesion on baseline MRI demonstrated two characteristics that were atypical for stroke: it had an ovoid shape and a subtle T2 hypointense core. This case demonstrates that acute clinical and radiographic presentation of cerebral abscess and ischemic stroke can be strikingly similar. Follow-up imaging can be instrumental in arriving at an accurate diagnosis. MDPI 2020-07-11 /pmc/articles/PMC7408080/ /pubmed/32664484 http://dx.doi.org/10.3390/brainsci10070440 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Jeong, Da-Eun Lee, Jun Brain Abscess Masquerading as Brain Infarction |
title | Brain Abscess Masquerading as Brain Infarction |
title_full | Brain Abscess Masquerading as Brain Infarction |
title_fullStr | Brain Abscess Masquerading as Brain Infarction |
title_full_unstemmed | Brain Abscess Masquerading as Brain Infarction |
title_short | Brain Abscess Masquerading as Brain Infarction |
title_sort | brain abscess masquerading as brain infarction |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408080/ https://www.ncbi.nlm.nih.gov/pubmed/32664484 http://dx.doi.org/10.3390/brainsci10070440 |
work_keys_str_mv | AT jeongdaeun brainabscessmasqueradingasbraininfarction AT leejun brainabscessmasqueradingasbraininfarction |