Contrast enhanced computed tomography in the early diagnosis of cerebral abscessBMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7204.239 (Published 24 July 1999) Cite this as: BMJ 1999;319:239
- Michael Owen Fitzpatrick, registrar,
- Peter Gan, senior house officer
- Department of Neurosurgery, Institute of Neurological Sciences, Southern General Hospital NHS Trust, Glasgow G51 4TF
- Correspondence to: Mr Fitzpatrick
- Accepted 29 January 1999
If a stroke is not straightforward, ask for a contrast enhanced computed tomogram
Despite advances in the management of cerebral abscess, this condition is still associated with appreciable morbidity and mortality. The key to successful treatment is early diagnosis, but this requires a high index of clinical suspicion and the correct choice of investigations Contrast enhanced computed tomography is the best investigation since non-contrast computed tomography does not identify all cerebral abscesses. To highlight this, we report two patients in whom the diagnosis was delayed because of failure to perform a contrast enhanced computed tomogram of the brain, and in whom delay may have resulted in a less favourable neurological outcome.
A 54 year old man presented to a district general hospital after a single grand mal seizure. Clinical examination showed a right hemiparesis and non-contrast computed tomography showed an area of low attenuation in the left temporal lobe which was reported as a temporal lobe infarct (figure, A). The patient had no further seizures, made a good recovery, and was discharged home 4 days after admission. Two weeks later he was readmitted because he had become confused. Repeat computed tomography of the brain showed that the area of low …
Log in using your username and password
Log in through your institution
Register for a free trial to thebmj.com to receive unlimited access to all content on thebmj.com for 14 days.
Sign up for a free trial