dizziness There is about 18mm sized restricted diffusion lesion with surrounding edema on the left basal ganglia especially centered on the left globus pallidus. The lesion shows irregular enhancement on Gad enhancement with central non enhancing portion. There is another focal enhancing lesion on the left internal capsule posterior limb as well as diffuse thick enhancement of the left parieto-temporal area pachymeninges.Surrounding edema extends toward left midbrain and there is midline shift toward left side and left lateral ventricle frontal horn appears to be compressed due to mass effects. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Peripheral irregular enhancing restricted diffusion mass with significant surrounding edema and mass effects on the left basal ganglia with another enhancing nodule on the left internal capsule posterior limb indicating possibility of brain abscess. Differential diagnosis include malignant tumor including metastasis.2. Relatively thick enhancing left parieto temporal area pachymeninges indicate associated meningitis.