Weekly Image Challenge – January 29, 2023

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?

  1. Glioblastoma
  2. Brain abscess
  3. Subacute infarct
  4. Radiation necrosis
  5. Metastasis


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.