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CASE OF THE MONTH

JULY 2023

Submitted by Aditya Bharatha MD FRCPC and Amy Chen MD FRCPC, Division of Neuroradiology, St. Michael’s Hospital, Unity Health, University of Toronto.

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65F post-op petrous meningioma ongoing fever and clinical signs of meningitis. Ventricular check.

FLAIR

T2W

Anchor 1

DIAGNOSIS

pMRI Findings:​

  • Stable ventricular volume compared to prior

  • New extra-axial FLAIR hyperintense collection lateral to the left cerebellum (previously suppressed as CSF on FLAIR)

  • Persistent left mastoid air cell fluid

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FLAIR

Diagnosis: Post-operative surgical bed empyema​

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Followup MRI confirming empyema, with restricted diffusion of the collection. Surgically confirmed.

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