Imaging of meningitis
Section snippets
Uncomplicated meningitis
In uncomplicated meningitis, most CT studies are normal despite the administration of contrast material.3 Similarly, about 50% of contrast enhanced MRI studies are also unremarkable. Differentiation of prominent enhancing arteries and veins in children may be difficult to distinguish from true pial enhancement as seen in meningitis. Occasionally, there may be swelling of the brain and extra-axial CSF-containing spaces may appear slightly wide.2 Enhancement of subarachnoid space is believed to
Hydrocephalus
Most hydrocephalus resulting from meningeal disease is of the communication type. Accumulation of an exudate is said to block the resorption of CSF by the Pachionian granulations, perivascular spaces, and the brain itself. Communicating hydrocephalus is the most common complication of bacterial meningitis. A mild degree of hydrocephalus is found in most patients with meningitis but in most of them this is a transient phenomenon.3 In some patients, the ventricular size never returns to normal
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Cited by (21)
Neuroimaging Patterns of Intracranial Infections: Meningitis, Cerebritis, and Their Complications
2023, Neuroimaging Clinics of North AmericaCitation Excerpt :MR imaging is most revealing; the ependyma enhances while the ventricles are dilated and filled with T2/FLAIR hyperintense, diffusion restricting purulent exudate (see Fig. 2; Fig. 20). Notably, higher ADC values might be observed from mixing of CSF and pus.7,21 Hydrocephalus in CNS infections varies from mild/transient (81% of cases) to severe (5%),78,79 which can lead to brain herniation and sudden death (see Fig. 9).
Bacterial, Viral, and Prion Infectious Diseases of the Brain
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2016, Handbook of Clinical NeurologyACR appropriateness criteria headache
2014, Journal of the American College of Radiology