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Please Advise
Feb 11, 2002

Dear Doctor, i contacted u a few days ago regardin brain abcess.We have now finally got the MRI report which is as follows : "There is evidence of intense ring enhancing mass lesions involving the superior cerebellar hemisphere on both sides along the tentorium. The superior cerebellar sulci also show intense enahncing abnormality on both sides.Partial compression of quadrigeminal cisterns noted.The rest of cisterns appear normal.Also ring enhancing lesions noted in the basal ganglia bilaterally.The ventrical and cerebral sulci appears normal for the age of the patient.NO midline shift seen. "

IMPRESSION - Features are in keeping with multiple Tuberculomas in the posterior fossa and in the basal ganglia.

Please advice on this as soon as possible.

Response from Dr. Young

Thanks for the update.

I'm not a radiologist, and I'm not sure that one can diagnose with certainty tuberculosis from a brain MRI scan; but there are certainly features from the scan that you describe that are suggestive of this diangosis (it is important to bear in mind that we typically prefer to have a tissue diagnosis in these settings).

Cerebral and cerebellar infections are serious, as you have saddly borne wittness to. What your friend needs is empiric initial treatment coupled to definative tissue-based diagnostics.

Hope things are improving. BY



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