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Brain Abscess after Endovascular Coiling of a Saccular Aneurysm: Case Report

Riyadh AL-Okailia and Sunil J. Patelb

a Departments of Radiology (R.A.-O.), Medical University of South Carolina, Charleston
b Departments of Neurological Surgery (S.J.P.), Medical University of South Carolina, Charleston



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  		FIG 1. MR images of the brain of a 70-year-old woman show a thrombosed aneurysm after endovascular coiling, with adjacent ring-enhancing lesion representing an abscess involving the brainstem and the right basal ganglia region.

A, Axial nonenhanced T1-weighted MR image (400/8/2 [TR/TE/NEX]), obtained through the pons, shows a focal low-intensity area.

B, Axial contrast-enhanced T1-weighted MR image (500/8/2), obtained through the pons, shows a ring-enhancing lesion.

C, Axial contrast-enhanced T1-weighted MR image (500/8/2), obtained through the midbrain, shows a ring-enhancing lesion adjacent to a thrombosed right posterior communicating artery aneurysm.

D, Coronal contrast-enhanced T1-weighted MR image (400/8/2), obtained through the brainstem, shows an oblong curved ring-enhancing lesion wrapping over a thrombosed right posterior communicating artery aneurysm.



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  		FIG 2. MR images of the brain, obtained approximately 2 weeks after completion of the 6-week antibiotic course, show interval near total resolution of edema and enhancement.

A, Axial nonenhanced T1-weighted MR image (500/11/2), obtained through the pons, shows no focal low-intensity area.

B, Axial contrast-enhanced T1-weighted MR image (500/11/2), obtained through the pons, shows that the ring-enhancing lesion has resolved.

C, Axial contrast-enhanced T1-weighted MR image (500/11/2), obtained through the midbrain, shows resolution of the ring-enhancing lesion adjacent to a thrombosed right posterior communicating artery aneurysm.

D, Coronal contrast-enhanced T1-weighted MR image (450/11/2), obtained through the brainstem, shows resolution of the ring-enhancing lesion adjacent to a thrombosed right posterior communicating artery aneurysm.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X