Findings
- T2 axial image shows T2 hyperintense signal intensity involving the left external auditory canal, middle ear cavity and mastoid air cells. They show diffusion restriction with peripheral enhancement with subcutaneous abscess in the left retroauricular location.
- Peripherally enhancing lesion with diffusion restriction in the left hemicerebellum is suggestive of abscess. Overlying leptomeningeal enhancement suggests meningitis. In the fourth image(axial post-contrast), small defect is seen in the sinodural plate through which intracranial extension of the infectious pathology has occurred resulting in cerebellar abscess.
Diagnosis
Otomastoiditis with intracranial spread and cerebellar abscess
Summary
Intracranial extension of infectious process is a very crucial complication of otomastoiditis and leads to fatal outcome. While reporting HRCT temporal bone for such cases, care must be taken to advice CEMRI Brain in case bony defects are observed.
Further reads
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057212/
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