Ring enhancing brain lesions: A Radiology Differential Diagnostic Challenge

Konstantina Ioannidou, Alexandra Paresi, Georgia Papavasileiou


A 48-year-old female patient was admitted to our hospital, with progressively worsening right hemiparesis and an episode of seizure.

The patient reported a history of a dental abscess that has been surgically drained 4 weeks ago. She had been under antibiotics for her odontogenic infection for 2 weeks. At presentation she reported headache, dizziness and mild numbness of her right arm. Her blood tests showed mild elevation of white blood cells and neutrophils but were otherwise unremarkable.

A brain Computed Tomography (CT) scan (Fig 1a,1b) was performed upon arrival at the Emergency department and a brain Magnetic Resonance Imaging (MRI) study was performed the next day. The MRI protocol included FLAIR and T2WI (Fig 2a,2b), T1WI post contrast (Fig 3), diffusion weighted images and ADC map (Fig 4a,4b). Magnetic resonance spectroscopy (MRS) was also performed (Fig 5a,5b).


MRI; MRS; Diffusion; brain abscess

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DOI: http://dx.doi.org/10.36162/hjr.v7i1.421


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