Brain abscess CT

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farwa Haideri [2]

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Overview

The diagnosis of brain abscesses is established by a computed tomography (CT) scan with contrast.

CT

CT scans can be used to evaluate all cranial structures including the paranasal sinuses, mastoids, and the middle ear. They can detect edema, hydrocephalus, shifts, or ventricular ruptures. At the initial phase of the inflammation (referred to as cerebritis), the immature lesion does not have a capsule and it may be difficult to distinguish it from other space-occupying lesions or infarcts of the brain. Within 4-5 days, the inflammation and the concomitant dead brain tissue are surrounded with a capsule, which gives the lesion the famous ring-enhancing appearance on CT examination with contrast (since intravenously applied contrast material can not pass through the capsule, it is collected around the lesion and looks as a ring surrounding the relatively dark lesion).

Lumbar puncture procedure, which is performed in many infectious disorders of the central nervous system, is contraindicated in this condition because removing a certain portion of the cerebrospinal fluid (CSF) may alter the concrete intracranial pressure balances and cause a part of the brain tissue to move out of the skull (brain herniation).