KINDERRADIOLOGIE ONLINE - view radiology images and radiology cases
Lesen Sie diese Seite auf Deutsch   Read this page in English
The Peer Reviewed Pediatric Radiology Platform on the Web
ISSN: 1942-955X :: Publisher: EduRad ::Editor-In-Chief: Roland Talanow, MD, PhD  
Browse Browse || Search Search || Online Book Systematically Online Book Systematically || Discussion Forum Discussion Forum || News News || Submit a Case Submit a Case || Rules Rules |
Most Interesting Cases Most Interesting Cases || "Most Diligent" Authors "Most Diligent" Authors || Case of the Day Case of the Day || Teaching files Teaching files || Links Links |
Newsletter Newsletter || Start Start || Survey Survey || Your Opinion Your Opinion || My Profile My Profile || CME-Credits CME-Credits |
    Pediatric Radiology News / Ads / Jobs Get the Pediatric Radiology News as RSS feed !
    Send us your news or ads for free
  • Surveillance imaging and radiation exposure in the detection of relapsed neuroblastoma.... (Pediatr Blood Cancer)
  • An observational study using ultrasound to assess physiological changes following fluid bolus admini... (BMC Pediatr)
  • Diagnosis of a Peritonsillar Abscess by Transcutaneous Point-of-Care Ultrasound in the Pediatric Eme... (Pediatr Emerg Care)
  • CME Kurs: Paediatric Body MRI

  • CME course: Paediatric Body MRI

  • Universitätsklinikum Jena sucht eine Ärztin/einen Arzt in Weiterbildung in Vollzeit

  • Kinderspital Zürich sucht Oberärztin / Oberarzt (100 %)

  • Kinderradiologische Oberärztin / Oberarzt gesucht

  • 2 Stellen in der Kinderradiologie - 1 Assistenzärztin/Assistenzarzt und 1 Oberärztin/Oberarzt in Voll- oder Teilzeit

  • Senior Paediatric Radiologist in Pediatric Radiology section needed

  • Facharzt als Oberärztin / Oberarzt in Sektion Kinderradiologie gesucht

  • Stellenangebot für Assistenzarzt (m/w) zur Facharztausbildung für RADIOLOGIE und/oder KINDERRADIOLOGIE

  • „Fellow“-Stelle zur Weiterbildung in Pädiatrischer Radiologie am Kinderspital Zürich

  • Fellow-Stelle Pädiatrische Neuroradiologie

  • FFF Kinderradiologie - Muskuloskelettale Radiologie im Kindesalter (Fit für den Facharzt)

  • Assistenzarzt für Kinderradiologe gesucht an Universitätsklinikum Schleswig-Holstein, Campus Kiel

  • Turnusarzt (m/w) in Ausbildung zum Facharzt (m/w) für Radiologie

  • Assistenzarzt (m/w) zur Weiterbildung im Schwerpunkt Kinderradiologie

  • Send us your news or ads for free

    Get the Pediatric Radiology News as RSS feed !


    Radiolopolis

    The dynamic Radiology community for education, research and practice


     

    Go to the top of the page   ID: 20031225185135 Original case in english  More links about this topic on Pubmed (PubMed Reader)
    Add this case to your RSS feeder: Subscribe to RSS feed Add to Yahoo Add to Google Add to AOL Add to Furl Subscribe to Feed Burner feed

    Bookmark and Share


    | The Authors | Discussion | Write a Comment to this Case |
    | Evaluate this Case | Recommend this Case to a Colleague | Survey Results |
    | Citation | Similar Cases | Similar Cases in the Internet | Images to this Case |
     
    Brain Abscess with Frontal Sinus Defect
    Ina Sorge. Brain Abscess with Frontal Sinus Defect. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031225185135


     
     Pediatric Radiology CasesImages to this case: There are CT-images available for this case. [ CT ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Ina Sorge (Universität Leipzig)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    9 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    Head-Brain and brain nerves  

     
     Pediatric Radiology CasesMost likely etiology:

    inflammatory or infectious  

     
     Pediatric Radiology CasesHistory:

    9 year-old boy, images received from an outside hospital after a longstanding nasopharygeal viral infection. Spiking fevers up to 40° C have been reported. Now, after a fall, the patient is dazed. The patient underwent a CT with the concern for cerebral hemorrhage. Only mild leucocytosis.

    CT 1: slight frontal edema bilaterally. Result of trauma? Infection? After 5 days, the child was transferred to the children's hospital because of progressing impairment of consiousness.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Proof of pathogen in the abscesses: Staphylococcus.

    The etiology of bacterial cerebral abscesses can be hematogenic (often endocarditis), after trauma or can be due to direct extension from a neighbouring infectious process. A common cause is sinusitis with a concurring bony defect in the posterior wall of the frontal sinus (as in this case). In immune-competent patients, fungal pathogens should also be considered besides a bacterial infection.
     

     
     Pediatric Radiology CasesRadiological findings:


    CT 1 <- view CT 1

    CT 1: outside CT: Bifrontal hypodensities (edema): Result of trauma after fall?




    MRI 1 <- view MRI 1

    MRI 1: T1-weighted image after contrast administration directly after admission: Bifrontally, two large colliquation zones with intense wall enhancement.




    MRI 2 <- view MRI 2

    MRI 2: T1-weighted after contrast administration directly after admission: Subdural and epidural fluid capsule with intense wall enhancement frontoparietal as well as temporal and basal.




    MRI 3 <- view MRI 3

    MRI 3: No MRI, rather a supplemental CT: Left upper corner: Single slice in bone window. Right lower corner: 3D reconstruction in the area of the frontal sinuses: Defect in the right, posterior frontal sinus wall.




    MRI 4 <- view MRI 4

    MRI 4: T1-weighted, after contrast administration: Treatment of the frontal sinuses in the ENT unit, neurosurgical trepanation on the right side. The intraparenchymal changes do not show any change (increase of the focal edema, on T1-weighted images signal focal signal loss)




    MRI 5 <- view MRI 5

    MRI 5: T1-weighted, after contrast administration: After 2 months of conservative treatment and without further surgical intervention (hyperbaric oxygenation, antibiotics), further decrease of the frontal intracerebral lesions. Only small enhancing rests left with minimal surrounding residual edema.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Surgery / Histo  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Glioblastoma, in a purely intracerebral location also pilocytotic astrocytoma  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Clinically it often starts subtle. Commonly, there is only a moderate leucocytosis. In chronic courses and a thick abscess membrane, it might be mistaken with a glioblastoma multiforme is possible, since both changes commonly show a perifocal edema.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    Giannoni C, Sulek M, Friedman EM.
    Intracranial complications of sinusitis: a pediatric series.
    Am J Rhinol. 1998 May-Jun;12(3):173-8.

    2. Medline: Medline
    Lee GY, Daniel RT, Brophy BP, Reilly PL.
    Surgical treatment of nocardial brain abscesses.
    Neurosurgery. 2002 Sep;51(3):668-71  

     
     Pediatric Radiology CasesKeywords:

    Brain, Abscess, Frontal, Sinus, Brain abscess with frontal sinus defect, sinus frontalis, Brain abscess, Frontal sinus, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Ina Sorge. Brain Abscess with Frontal Sinus Defect. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031225185135  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Head-Brain and brain nerves
    or in the region: Head
    or in the tissue/organ: Brain and brain nerves
    or with the etiology: inflammatory or infectious
     
     Pediatric Radiology CasesImages to this case: There are CT-images available for this case. [ CT ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Brain Abscess with Frontal Sinus Defect
    Ina Sorge. Brain Abscess with Frontal Sinus Defect. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031225185135


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Brain Abscess with Frontal Sinus Defect
    Other cases by these authors:

    Search Ina Sorge in Medline Ina Sorge (8)   

    Brain Abscess with Frontal Sinus Defect  
     
    Brain Abscess with Frontal Sinus Defect
    Ina Sorge. Brain Abscess with Frontal Sinus Defect. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031225185135


     

    Which diagnosis have other collegues guessed?


    • Glioblastoma multiforme
      Votes: 2 (9 %)


    • Cerebral abscess after trauma
      Votes: 4 (18 %)


    • Cerebral abscess after sinusitis
      Votes: 15 (68 %)


    • Necrotic encephalitis
      Votes: 1 (4 %)



        Total answers: 22

     
    Brain Abscess with Frontal Sinus Defect
    Ina Sorge. Brain Abscess with Frontal Sinus Defect. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031225185135


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    How interesting was this case for you?
    (10 = most interesting || 1 = less interesting)
     
    Brain Abscess with Frontal Sinus Defect
    Ina Sorge. Brain Abscess with Frontal Sinus Defect. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031225185135


     




    Discussion >> Write Comment <<



      There are no comments available regarding this case.





     Write a comment to this case (With * marked fields have to be filled)

    Type in this number: 5461

    Name: *

    E-Mail:

    Website:

    Subject: *

    Text: *




     
      Pediatric Radiology Discussion Get the Pediatric Radiology Discussion as RSS feed !
      To the discussion forum
      To the discussion forum

      Get the Pediatric Radiology Discussion as RSS feed !

      © 2001-2016   www.kinderradiologie-online.de
      In cooperation with © Radiolopolis - Radiology Search - Radiology Teacher - PubMed Reader - Annotate - Radiology Lectures & Tutorials - Radiology Boards Preparation - Pediatric Radiology Links - Pediatric Radiology Information - Emergency Radiology - Lung Cancers - USMLE Forums - Cancer Staging Information - Chest Radiology - Radiology Case Report Journal
      For suggestions and questions: information@kinderradiologie-online.de
      Add this site to your favorites (CTRL+D)