Nonspecificity of ring enhancement in "medically cured" brain abscess

Since the introduction of computed tomography (CT), there have been numerous reports of brain abscess treated successfully without surgery. Because pathologic confirmation was lacking in these patients, diagnosis was based on CT abnormalities, usually ring enhancement. However, our recent clinical e...

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Bibliographic Details
Published inNeurology Vol. 34; no. 2; p. 139
Main Authors Dobkin, J F, Healton, E B, Dickinson, P C, Brust, J C
Format Journal Article
LanguageEnglish
Published United States 01.02.1984
Subjects
Adult
Anti-Bacterial Agents - therapeutic use
Brain Abscess - diagnostic imaging
Brain Abscess - drug therapy
Diagnosis, Differential
Encephalitis - diagnostic imaging
Female
Humans
Image Enhancement
Lung Abscess - complications
Male
Middle Aged
Tomography, X-Ray Computed
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Summary:Since the introduction of computed tomography (CT), there have been numerous reports of brain abscess treated successfully without surgery. Because pathologic confirmation was lacking in these patients, diagnosis was based on CT abnormalities, usually ring enhancement. However, our recent clinical experience and the experimental work of others indicate that the "ring sign" on contrast-enhanced CT is not absolutely diagnostic of encapsulated brain abscess. Moreover, in the reported cases of alleged brain abscess cured medically, atypical clinical features suggest that some patients may have had cerebral infarction or cerebritis. Stricter clinical and radiologic criteria are needed before concluding that encapsulated brain abscess can be cured by medical therapy alone.
ISSN:0028-3878
1526-632X
DOI:10.1212/WNL.34.2.139