42-year-old male with left anterior mesiofrontal abscess s/p drainage and antibiotics IV and PO. Evaluate for changes of drained abscess. Since the prior exam there has been interval decrease in size of the left gyrus rectus enhancing lesion compatible with abscess. It now measures 0.7 x 0.5 cm (series 12, image 63), compared to 1.1 x 1.7 cm previously. The amount of surrounding T2/FLAIR signal abnormality within the left frontal lobe has decreased significantly. Foci of encephalomalacia are present in medial left occipital lobe and in the left cerebellar hemisphere. These are stable compared to the prior exam. There are several periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. A linear focus of T2 and FLAIR signal hyperintensity extends through the left frontal calvarial burr hole into the left frontal lobe lesion. This probably represents a prior tract for biopsy/aspiration.The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1.Interval decrease in size in the left frontal lobe abscess with corresponding decrease in the amount of surrounding edema. 2.Foci of encephalomalacia are redemonstrated in the left cerebellar hemisphere and left occipital lobe which are most likely related to a prior cerebrovascular event. This is stable and unchanged.