Introduction: Pyogenic ventriculitis is an uncommon but often severe intracranial infection.
Methods: Case report with illustrative CT and MRI imaging.
Results: A 49-year-old man presented with an intraparenchymal hematoma with extension of blood into the ventricles. The persistence of intraventricular blood necessitated long term placement of an external ventricular drain. On day 23 after admission, a contrast-enhanced CT scan of the brain showed slight hydrocephalus, irregular debris in the dependent part of the occipital horns and periventricular hypodensities. An MRI scan confirmed the characteristic hallmarks of pyogenic ventriculitis on the T2-weighted, Fluid Attenuated Inversion Recovery (FLAIR), and diffusion-weighted and contrast-enhanced T1-weighted images.
Conclusion: Neuroimaging is crucial in clearly depicting pyogenic ventriculitis. A contrast-enhanced CT scan, but especially MR imaging, is an ideal tool to reliably diagnose this life-threatening cerebral infection.