Ring-enhancing lesion: Difference between revisions
Neil.m.young (talk | contribs) No edit summary |
ClaireLewis (talk | contribs) No edit summary |
||
| (One intermediate revision by one other user not shown) | |||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*CT or MRI with lesions having an enhancing ring of contrast around a less dense center can indicate certain neurological infections, injuries, and indolent disorders | *[[head CT|CT]] or [[brain MRI|MRI]] with lesions having an enhancing ring of contrast around a less dense center can indicate certain neurological infections, injuries, and indolent disorders | ||
*Immune status of patients is key in helping to narrow potential causative agents | *Immune status of patients is key in helping to narrow potential causative agents | ||
| Line 17: | Line 17: | ||
==Management== | ==Management== | ||
*Focused treatment plan based on etiology | |||
==Disposition== | ==Disposition== | ||
| Line 32: | Line 33: | ||
[[Category:Radiology]] | [[Category:Radiology]] | ||
[[Category:Neurology]] | |||
Latest revision as of 01:21, 2 October 2019
Background
- CT or MRI with lesions having an enhancing ring of contrast around a less dense center can indicate certain neurological infections, injuries, and indolent disorders
- Immune status of patients is key in helping to narrow potential causative agents
Clinical Features
- Clinical presentation can vary from asymptomatic to focal neurodeficits to coma
Differential Diagnosis
Ring-Enhancing Lesion
Common Mnemonic: DR MAGIC
- Demyelination
- Radionecrosis/hematoma
- Metastasis
- Abscess (consider bacterial, fungal, parasitic)
- Glioma (and other primary neoplasms such as lymphoma)
- Infarction
- Contusion
HIV and ring-enhancing lesion(s)
- Toxoplasmosis v. lymphoma (see comparison of characteristics at Radiopaedia.org.)
Neoplasm
- Primary brain tumor
- Primary CNS lymphoma
- Metastatic disease
Infectious
- Pyogenic brain abscess
- Tuberculoma
- Toxoplasmosis
- Syphilis
- Neurocysticercosis
- Nocardiosis
- Cryptococcosis
- Aspergillosis
Neurologic
- Multiple Sclerosis
- Sarcoidosis
- Vasculitis
- Aneurysm
- Resolving hematoma
- Cerebral infarct
- Post-op changes
Evaluation
- Ring-enhancing lesion is a radiologic diagnosis
- Workup must be directed towards presentation, comorbidities, and risk factors
Management
- Focused treatment plan based on etiology
Disposition
- Typically require admission for further work up