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Cerebral ventricular empyema associated with severe adult pyogenic meningitis: computed tomography findings
R Bakshi1, P R Kinkel, L L Mechtler
1Millard Fillmore Health System, Dent Neurologic Institute, Department of Neurology, State University of New York at Buffalo School of Medicine and Biomedical Sciences, USA. rbakshi@ubmedh.buffalo.edu
Abstract:
Cerebral ventricular empyema (CVE), also known as pyocephalus, is a rare form of pyogenic ventriculitis. We present cranial computed tomography (CT) in an adult who developed a bilateral CVE associated with acute pyogenic meningitis. CT showed an obstructive ventriculomegaly and fluid-fluid levels layering in the lateral ventricles and the third ventricle. Frank neutrophilic pus was taken from the subarachnoid space. After antibiotic treatment, the pyocephalus resolved. CVE may be visualized on CT with pus layering in the ventricular CSF, creating a fluid level of intermediate hypodensity.