Intraventricular Rupture of a Cerebral Abscess

Figure 1. Cerebral imaging studies were performed in a 53-year-old man with a one-week history of headache, ataxia, and disorientation that culminated in right hemiparesis and coma. He had a remote history of dental abscesses. Magnetic resonance imaging with gadolinium enhancement (Panel A) shows a left frontal lesion (arrow) in communication with the left lateral ventricle. Purulent material containing Streptococcus anginosus was obtained by ventriculostomy, and both intrathecal and intravenous antibiotics were given. A contrast-enhanced computed tomographic scan obtained after four weeks of treatment (Panel B) shows loculation of the left lateral ventricle (arrowheads) and transependymal edema (arrows). The patient . . .