Section 2 - Other CNS disease related to underlying and secondary effects of malignancy

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Infection : Intracranial Infection

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Case 18

 A 22 year old male with AML and severe neutropenia
This patient developed right-sided V2 and sixth cranial nerve palsies, and a CT was obtained (18A). Only minimal opacification of the right sphenoid sinus was seen.

The patient deteriorated and follow-up MRI performed 37 hrs later (noncontrast axial T1, 18B), showed far more extensive right-sided sinonasal involvement (thick arrows), but also intracranial extension. Note the abnormal hypointense signal of the right temporal lobe (thin arrows) indicating edema. Despite antifungal therapy, this patient rapidly succumbed to this Mucor infection.

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