Multiple bilateral cerebral abscesses with hemorrhage

Brain abscess with spontaneous hemorrhage is an uncommon illness. A rare case of multiple abscesses in both cerebral hemispheres complicated by hemorrhage is reported. Minimally invasive surgery utilizing magnetic resonance imaging (MRI) guidance was performed after extensive testing failed to yield a diagnosis. Streptococcus intermedius was isolated from cultures taken during surgery and intravenous antimicrobial therapy was instituted. Pathology other than metastatic neoplasms and subacute hemorrhage should be considered in cases of cerebral ring-enhancing masses with hemosiderin deposition.