Contrast enhanced computed tomography in the early diagnosis of cerebral abscess

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.