The printable version is no longer supported and may have rendering errors. Please update your browser bookmarks and please use the default browser print function instead.
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)
Neoplasm
Infectious
Neurologic
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
See Also
External Links
References