A 2 yr old DSH female neutered cat initially presented for evaluation of a few days history of rapidly progressive forebrain signs, more pronounced on the left side.

 

MRI showed at the time an extensive extra-axial/subdural space occupying lesion affecting the whole left side of the rostral cranial fossa from the olfactory bulb to the most caudal aspect of the occipital lobe. This lesion was mildly heterogeneous, mainly hyperintense in T2W and FLAIR when compared to gray matter and isointense in T1W. After contrast, there was marked diffuse contrast enhancement of the meninges surrounding non-enhancing material with splitting of the contrast (indicating meningeal/dural enhancement and a necrotic non-enchanced center). There was severe mass effect with midline shift, transtentorial and cerebellar herniation. No calvarial lesion was identified. The ear and retrobulbar spaces were normal.

 

This cat was managed medically with intravenous dexamethasone for the first 48 hours and broad-spectrum antibiotics. Follow-up MRI done 6 weeks later showed complete resolution of this lesion and neurological examination was normal.

​

Click on the link below to access more information about cats with intracranial empyema.

​

Courtesy of Dr. Laurence Doddy at Swift Referrals in England.

​

​