Board Review 1 – Case 9

Neuroradiology board review. This lecture is geared towards the ABR core exam for residents, but it would be useful for review for the ABR certifying exam or certificate of added qualification (CAQ) exam for neuroradiology.

More description and the answer (spoiler!) are seen below the video.

This case shows multiple areas of intracranial edema with post-contrast enhancement in a patient with HIV. The key to the diagnosis in this case is the appearance on diffusion weighted imaging (bright) and ADC, consistent with centrally reduced diffusion.

The diagnosis is: intracranial abscess

Intracranial abscesses are parenchymal collections of pus within the brain. Their key feature is peripheral enhancement with centrally reduced diffusion. They are more common in immune suppressed patients.