Computerized tomography is not reliable in the diagnosis of brainstem infection.
The case of a 17-year-old girl who presented with a two-day history of absolute dysphagia secondary to a bulbar palsy due to a pre-pontine abscess is described. Rigid oesophagoscopy was normal and a neurology consultation suggested a central cause for her dysphagia. However the diagnosis was delayed because a computed tomography (CT) scan of her brain and brainstem was reported as normal. A subsequent magnetic resonance image (MRI) scan revealed a pre-pontine abscess. CT scanning is not as reliable as MRI in the diagnosis of infective lesions of the brainstem/brain, especially early in the course of the infection.
Walshe
Peter
P
Department of Otolaryngology-Head and Neck Surgery, Beaumont Hospital, Dublin. rmwalsh@rcsi.ie
Brennan
Paul
P
Walsh
Michael
M
McConn Walsh
Rory
R
D000293:Adolescent; D001922:Brain Abscess / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D003680:Deglutition Disorders / Q000209:etiology; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D011149:Pons / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed