MRI (T1 with contrast) showing the ring-enhancing lesion. From a rare case report of an<unk>  formed as a complication of the CSF shunt. Jamjoom et al., 2009. The diagnosis is established by a computed tomography (CT) (with contrast) examination. At the initial phase of the inflammation (which is referred to as cerebritis), the immature lesion does not have a capsule and it may be difficult to distinguish it from other space-occupying lesions or infarcts of the<unk> . Within 4–5 days the inflammation and the concomitant dead<unk>  tissue are surrounded with a capsule, which gives the lesion the famous ring-enhancing lesion appearance on CT examination with contrast (since intravenously applied contrast material can not pass through the capsule, it is collected around the lesion and looks as a ring surrounding the relatively dark lesion). Lumbar puncture procedure, which is performed in many infectious disorders of the central nervous system is contraindicated in this condition (as it is in all space-occupying lesions of the<unk>  because removing a certain portion of the cerebrospinal fluid may alter the concrete intracranial pressure balances and causes the<unk>  tissue to move across structures within the skull<unk>  herniation). Ring enhancement may also be observed in cerebral hemorrhages (bleeding) and some<unk>  tumors. However, in the presence of the rapidly progressive course with fever, focal neurologic findings (hemiparesis, aphasia etc.) and signs of increased intracranial pressure, the most likely diagnosis should be the<unk> .
Brain abscess
Epidural hematoma
Brain metastasis
Subdural empyema
Amoebic brain abscess
Leptomeningeal cancer
Meninges
Coma