MRI and clinical resolution of a suspected intracranial toxoplasma granuloma with medical treatment in a domestic short hair cat

Abstract

A two-year-old cat was presented with a left paradoxical vestibular syndrome. MRI of the brain revealed an extraaxial homogenously contrast enhancing mass in the region of the left caudal cerebellar peduncle. Toxoplasma serology was consistent with active infection and the lesion was suspected to be a toxoplasma granuloma. Following eight weeks of tapering oral prednisolone and 11 weeks of oral clindamycin treatment, repeat MRI revealed resolution of the lesion. Eighteen months after initial diagnosis, the cat remained neurologically normal. Differential diagnoses for a solitary, extra-axial, contrast enhancing mass lesion in the feline brain should include toxoplasma granuloma, which can undergo MRI and clinical resolution with medical treatment.