69 year old female with retropharyngeal abscess. Worsening clinical symptoms. Increasing neurological symptoms. Evaluate for spread. CT of the soft tissues of the neck.Images through the skull base including cavernous sinuses remain within normal limits.Images through the soft tissues of the neck demonstrate a prevertebral edema enhancing fluid collection which also contains air and is consistent with patient's diagnosis of prevertebral abscess in comparison with the prior exam no definitive evidence of interval change is noted however on this the study extension of the abscess to the level of left neural foramina at C6- C7 is better visualized. Prior MRI of cervical spine also demonstrate ventral epidural spread of infection at this level. There may be slight increase in the size of prevertebral abscess. Images through the apices of the lungs demonstrate significant bilateral pleural effusions that appears more pronounced (on the right side) since prior examination.CT of brain with infusion.No evidence of any abnormal enhancement of brain parenchymal or the leptomeninges is identified to suggest intracranial spread of infection. No evidence of edema, mass effect, midline shift, hydrocephalus is detected. Cortical sulci, ventricular system and all CSF cisterns remain within normal limits.If worsening of neurological symptoms are relevant to the spine repeat MRI examination of cervical and thoracic spine is recommended.
1.Negative CT of brain with infusion.2.Redemonstration of prevertebral abscess with possible slight interval increase in its size.