49-year-old male.

History - bizarre behaviour for several weeks more rapid deterioration over past few days.

■ Describe the abnormal radiological signs (Figs 5.28 and 5.29).

■ What is the differential diagnosis?

■ What urgent management should be considered?

Fig. 5.30 Ring-enhancing lesion post-contrast. This is a further example of a malignant glioma. The differential for this lesion includes an abscess and clinical correlation is necessary (clinical history, temperature, inflammatory markers - CRP, leucocyte count). Abscesses are typically thin walled with surrounding oedema.

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