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Images in Neurology |

Cerebral Abscess Due to Sinusitis

Panagiotis Papanagiotou, MD; Iris Quasar Grunwald, MD; Maria Politi, MD; Wolfgang Reith, MD
Arch Neurol. 2008;65(5):668-669. doi:10.1001/archneur.65.5.668.
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A 12-year-old boy presented to the emergency department following a generalized tonic-clonic seizure lasting 5 minutes. He had had a 6-day fever with a severe frontal headache and progressive ideomotor impairment.

On examination, the child had a body temperature of 40°C. There was no focal neurological deficit. His cranial nerves were intact and muscle tone, power, and reflexes were normal with flexor plantar responses. He had no objective signs of neck stiffness and a negative Kernig sign. Funduscopy results were normal with no evidence of papilledema. Other systemic examination findings were unremarkable. Laboratory findings revealed a peripheral leukocyte count of 11 400 cells/μL (to convert to × 109/L, multiply by 0.001), while other findings were in the normal range.

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Figure 1.

Coronal fast fluid-attenuated inversion recovery magnetic resonance imaging showed hyperintense edema (white arrows) surrounding the cerebral abscess as well as inflammatory tissue and secretions within the left frontal, ethmoidal, and maxillary sinuses (black arrows).

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Figure 2.

Sagittal postcontrast T1-weighted image. A hyperintense capsule corresponding to a well-defined abscess wall (white arrows) and strongly hyperintense signals consistent with secretions in the frontal sinus were observed (black arrows).

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