What is the most likely diagnosis for these scans of a 70 years old patient who had presented with seizures and altered level of consciousness?
- Brain abscess
- Subacute infarct
- Radiation necrosis
Congratulations to those who had selected brain abscess. The uneven and thick rim enhancement pattern and central diffusion restriction were the main points differentiating it from a high-grade glioma.
An infarct would involve vascular territory.
This patient doesn’t have a history of radiation.
Metastasis more commonly involves the posterior fossa, is often dural based, and can be multiple.