Patients in the early cerebritis
stage or those with abscesses that are smaller than 2.5cm may undergo aspiration for diagnosis only.
Of these, one child had early cerebritis
changes in temporal lobe with facial nerve paresis (Fig 3).
Forty two patients (55.3%) had nephritis, 20 patients (26.3%) had lupus cerebritis
, 57 patients (75%) had hematological involvement, 9 patients (11.83%) had pulmonary involvement, 8 patients (10.5%) had rheumatoid arthritis (RA) factor positive and 7 patients (9.2%) had overlap syndrome.
In earlier stages of brain abscess called cerebritis
, the suppurative lesion is poorly demarcated from surrounding brain.
At this point CJD was considered among other possible etiologies such as paraneoplastic encephalitis, meningeal carcinomatous, infectious cerebritis
, and primary CNS angiitis given his continued deterioration and refractory status epilepticus.
The cause of death was brain abscess in 57% patients, meningitis or cerebritis
in 14% patients, and intracranial hemorrhage in 29% patients.
The most common central nervous system manifestation is meningitidis, while meningoencephalitis, rhombencephalitis, and cerebritis
are less common .
CNS tuberculosis can manifest in a variety of forms, including tuberculous meningitis, tuberculomas, tuberculous abscesses, tuberculous cerebritis
, and miliary tuberculosis.
and cerebral vasculitis are a possibility as well and share some of the symptoms already mentioned.
The lesion evolves from early cerebritis
to the stage of organization and capsule formation which is wellvascularized.2,3 The mode of entry of organisms could be by contiguous spread, hematogenous dissemination, or following trauma.4
This inflammatory lesion may propagate endocranially, resulting in acute meningitis, epidural abscess, subdural empyema, cavernous sinus trombophlebitis, cerebritis
, and frontal lobe abscess of the brain.