Cerebellar abscess diagnosis [Neurosurgery Wiki]

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====== Cerebellar abscess diagnosis ======

==== CT ====

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A [[hypodense]] [[area]] with an [[air fluid level]] within it of approximately 4.4 cm x 3.6 cm is visualized, in the left [[cerebellar hemisphere]], which enhances after IV [[contrast]] and causes a [[mass effect]] on the [[fourth ventricle]] and an increase in the ventricular size of the lateral [[horn]]s, in relation to [[cerebellar abscess]] with secondary [[hydrocephalus]]. Content is visualized inside the left [[mastoid]]. Hypodense foci in subcortical [[white matter]], predominantly bilateral frontoparietal, in [[semioval center]]s, [[corona radiata]], and periventricular, nonspecific, which could be related to small vessel ischemia, being very numerous for the patient's age. Hypodense foci in the left [[external capsule]] suggest Virchow-Robin spaces vs. chronic [[lacunar infarct]]ion. 

Findings in relation to an [[abscess]] in the left cerebellar hemisphere that causes [[hydrocephalus]], especially of the [[lateral ventricle]]s.



==== MRI ====

Conventional MRI sequences are able to diagnose most of the benign-appearing [[posterior fossa lesion]]s, however, adding advanced MRI sequences like [[diffusion-weighted imaging]] and [[Proton magnetic resonance spectroscopic imaging]] helps us to differentiate and diagnose various posterior fossa lesions even closer to the actual histopathological diagnosis
((Tamilchelvan P, Boruah DK, Gogoi BB, Gogoi R. Role of MRI in Differentiating Various Posterior Cranial Fossa Space-Occupying Lesions Using Sensitivity and Specificity: A Prospective Study. Cureus. 2021 Jul 12;13(7):e16336. doi: 10.7759/cureus.16336. PMID: 34395119; PMCID: PMC8357022.)).