Occult Cerebral Abscess Revealed by FDG PET/CT in a Case of Unresponsive Wakefulness Syndrome

Clin Nucl Med. 2019 Jan;44(1):57-58. doi: 10.1097/RLU.0000000000002335.

Abstract

A 51-year-old woman developed profound coma complicating subarachnoid hemorrhage after aneurysmal rupture. An external ventricular drain was inserted. FDG PET/CT was performed for prognostication purposes and showed global cortical hypometabolism. This was consistent with the clinical findings of an unresponsive wakefulness syndrome. During the follow-up, ventriculitis was diagnosed. Because of no clinical improvement under focused, high-dose antimicrobial treatment, a second FDG PET/CT was performed. It showed an improved diffuse cortical fixation and an intense intraventricular hyperfixation, suggestive of intraventricular abscess. A third functional imaging, performed to monitor treatment, showed progressive metabolic recovery with especially uptake in frontoparietal areas over time.

Publication types

  • Case Reports

MeSH terms

  • Brain Abscess / complications
  • Brain Abscess / diagnostic imaging*
  • Coma / diagnostic imaging*
  • Coma / etiology
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Middle Aged
  • Positron Emission Tomography Computed Tomography*
  • Radiopharmaceuticals
  • Wakefulness

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18