Neuroimaging pp 909-950 | Cite as

Infectious and Inflammatory Diseases of the Brain and Spinal Cord

  • Nadine Girard
  • Robert A. Zimmerman

Abstract

The ability to detect intracranial and spinal infection has progressively improved with first the introduction of computed tomography (CT) in 1973, and then magnetic resonance imaging (MRI) in 1982 (Table 24.1). CT is rapid; bone and blood are shown as areas of high density, while brain, cerebrospinal fluid (CSF), and air are shown as areas of lower density. Abnormalities of the paranasal sinuses and cranial vault can also be shown. Abnormalities of the blood—brain barrier (BBB) are shown, after the injection of intravenous iodinated contrast media, by producing contrast enhancement. MRI has a number of major advantages compared to CT: (1) Its multiplanar capability improves the evaluation of the extent of lesions; (2) its lack of bone artifacts improves the detection of the lesions in the posterior fossa and temporal lobes, as well as those involving meninges and dura matter, particularly on postcontrast scans; (3) MR is sensitive to alterations in brain water content, a condition seen in spine and parenchymal infections; and MR is highly sensitive in the detection of blood products within a hematoma whether acute, subacute, or chronic; and (4) MR is sensitive in demonstrating blood flow within arteries and veins. In addition, MR angiography (MRA) can be performed easily; MRA information is available on both the partition images, as well as the reconstructed maximum intensity projection (MIP) images.

Keywords

Lymphoma Tuberculosis Neurol Aspergillus Vasculitis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Zimmerman RA. Imaging of intracranial infections. In: Scheid WM, Whitley RJ, Durack DT, eds. Infections of the central nervous system. New York, Raven Press, 1991, pp. 887–907.Google Scholar
  2. 2.
    Smith RR. Neuroradiology of intracranial infection. Pediatr Neurosurg 1992; 18: 92–104.PubMedCrossRefGoogle Scholar
  3. 2a.
    Chimelli L, Mahler-Aravjo MB. Fungal infections. Brain Pathol 1997; 7: 613–627.PubMedCrossRefGoogle Scholar
  4. 3.
    Hatta S, Mochizuki H, Kuru Y, et al. Serial neuroradiological studies in focal cerebritis. Neuroradiology 1994; 36: 285–288.PubMedCrossRefGoogle Scholar
  5. 4.
    Sze G, Lee SH. Infectious diseases. In: Lee SH, Rao KCVG, Zimmerman RA, eds. Cranial MRI and CI, 3rd ed. New York, McGraw-Hill, 1992, pp. 539–588.Google Scholar
  6. 5.
    Sze G, Zimmerman RD. The magnetic resonance imaging of infections and inflammatory diseases. Radiol Clin North Am 1988; 26 (4): 839–859.PubMedGoogle Scholar
  7. 6.
    Zimmerman RD, Weingarten K. Neuroimaging of-cerebral abscesses. Neuroimag Clin North Am 1991; 1 (1): 1–16.Google Scholar
  8. 6a.
    Enzmann DR, Britt RR, Yeager AS. Experimental brain abscess evolution: Computed tomographic and neuropathologic correlation. Radiology 1979; 133: 113–122.PubMedGoogle Scholar
  9. 7.
    Barnes PD, Poussaint TY, Burrows PE. Imaging of pediatric central nervous system infections. Neuroimag Clin North Am 1994; 4 (2): 367–391.Google Scholar
  10. 8.
    Snyder RD. Bacterial infections of the nervous system. In: Swaiman KF, ed. Pediatric neurology: principles and practice. St. Louis, C.V. Mosby, 1989, pp. 447–473.Google Scholar
  11. 9.
    Fitz CR. Inflammatory diseases of the brain in childhood. AJNR 1992; 13: 551–567.PubMedGoogle Scholar
  12. 10.
    Fishman MA. Infectious diseases. In: David RB, ed. Pediatric neurology for the clinician. Norwalk, CT, Appleton and Lange, 1992, pp. 249–267.Google Scholar
  13. 10a.
    Gray F. Bacterial Infections. Brain Pathol 1997; 7: 629–647.PubMedCrossRefGoogle Scholar
  14. 11.
    Shaw DWW, Cohen WA. Viral infections of the CNS in children: imaging features. AJR 1993; 160: 125–133.PubMedGoogle Scholar
  15. 11a.
    Burke JW, Mathews VP, Elster AD, et al. Contrast-enhanced magnetization transfer saturation imaging improves MR detection of herpes simplex encephalitis. AJNR 1996; 17: 773–776.PubMedGoogle Scholar
  16. 12.
    Tien RD, Felsberg GJ, Osumi AK. Herpesvirus infections of the CNS: MR findings. AJR 1993; 161: 167–176.PubMedGoogle Scholar
  17. 13.
    Dyken PR. Viral diseases of the nervous system. In: Swaiman KF, ed. Pediatric neurology: principles and practice. St. Louis, C.V. Mosby, 1989, pp. 475–515.Google Scholar
  18. 14.
    Reik L. Immune-mediated central nervous system disorders in childhood viral infections. Semin Neurol 1982; 2 (2): 106–114.CrossRefGoogle Scholar
  19. 14a.
    Baum PA, Barkovich AJ, Koch TK. Deep gray matter involvement in children with acute disseminated encephalomyelitis. AJNR 1994; 15: 1275–1283.PubMedGoogle Scholar
  20. 15.
    Allen RJ. Neuroimmunologic disorders. In: David RB, ed. Pediatric neurology for the clinician. Norwalk, CT, Appleton and Lange, 1992, pp. 269–281.Google Scholar
  21. 16.
    Caldemeyer KS, Smith RR, Harris TM, Edwards MK. MRI in acute disseminated encephalomyelitis. Neuroradiology 1994; 36: 216–220.PubMedCrossRefGoogle Scholar
  22. 17.
    Baum PA, Barkovich AJ, Koch TK, Berg BO. Deep gray matter involvement in children with acute disseminated encephalomyelitis. AJNR 1994; 15: 1275–1283.PubMedGoogle Scholar
  23. 18.
    van der Meyden CH, de Villiers JFK, Middlecote BD, Terblanche J. Gadolinium ring enhancement and mass effect in acute disseminated encephalomyelitis. Neuroradiology 1994; 36: 221–223.Google Scholar
  24. 18a.
    Mader I, Stock KW, Ettlin T, Probst A. Acute disseminated encephalomyelitis: MR and CT features. AJNR 1996; 17: 104–109.PubMedGoogle Scholar
  25. 19.
    Menkes JH. Autoimmune and postinfectious diseases. In: Menkes JH, ed. Textbook of child neurology, 4th ed. Philadelphia, Lea & Febiger, 1990: 424–461.Google Scholar
  26. 20.
    Bell WE, McCormick WF. Acute cerebellar ataxia of childhood. In: Bell WE, McCormick WF, eds. Neurologic infections in children. Philadelphia, W.B. Saunders, 1975, pp. 433–437.Google Scholar
  27. 21.
    Tsuchiya K. Chronic viral infections simulating degenera¬tive diseases. Neuroimag Clin North Am 1991;1(1):201¬210.Google Scholar
  28. 21a.
    Morriss MC, Rutstein RM, Rudy B, Desrochers C, Hunter JV, Zimmerman RA. Progressive multifocal leuko¬encephalopathy in an HIV-infected child. Neuroradiology 1997; 39: 142–144.PubMedCrossRefGoogle Scholar
  29. 22.
    Rovira MJ, Post MJD, Bowen BC. Central nervous system infections in HIV-positive persons. Neuroimag Clin North Am 1991; 1 (1): 179–200.Google Scholar
  30. 23.
    Wiley CA, Belman AL, Dickson DW, Rubinstein A, Nelson JA. Human immunodeficiency virus within the brains of children with AIDS. Clin Neuropathol 1990; 9 (1): 1–6.PubMedGoogle Scholar
  31. 24.
    Brenneman DE, McCune SK, Gozes I. Acquired immune deficiency syndrome and the developing nervous system. Int Rev Neurobiol 1990; 32: 305–353.PubMedCrossRefGoogle Scholar
  32. 25.
    Belman AL. Acquired immunodeficiency syndrome and the child’s central nervous system. Pediatr Clin North Am 1992; 39 (4): 691–714.PubMedGoogle Scholar
  33. 26.
    Belman AL. AIDS and pediatric neurology. Neurol Clin 1990; 8 (3): 571–603.PubMedGoogle Scholar
  34. 27.
    Brouwers P, Belman AL, Epstein LG. Central nervous system involvement: manifestations and evaluation. In: Pizzo PA, Wilford CM, eds. Pediatric AIDS: the challenge of HIV infection in infants, children and adolescents. Bal¬timore, Williams & Wilkins, 1990, pp. 318–335.Google Scholar
  35. 28.
    Sharer LR, Epstein LG, Cho ES, et al. Pathologic features of AIDS encephalopathy in children: evidence for LAV¬HTLV-III infection of brain. Hum Pathol 1986; 17: 271–284.PubMedCrossRefGoogle Scholar
  36. 29.
    Civitello LA. Neurologic complications of HIV infection in children. Pediatr Neurosurg 1991–1992; 17: 104–112.Google Scholar
  37. 30.
    Kauffman WM, Sivit CJ, Fitz CR, Rakusan TA, Herzog K, Chandra RS. CT and MR evaluation of intracranial in¬volvement in pediatric HIV infection: a clinical-imaging correlation. AJNR 1992; 13: 949–957.PubMedGoogle Scholar
  38. 31.
    Epstein LG, Berman CZ, Sharer LR, Khademi M, Desposito F. Unilateral calcification and contrast en¬hancement of the basal ganglia in a child with AIDS en¬cephalopathy. AJNR 1987; 8: 163–165.PubMedGoogle Scholar
  39. 31a.
    Lexa FJ. Neuroradiological manifestations of acquired immunodeficiency syndrome. Sem Roentgenol 1994; 29: 288–302.CrossRefGoogle Scholar
  40. 32.
    Tien RD, Ashdown BC, Lewis DV, Atkins MR, Burger PC. Rasmussen’s encephalitis: neuroimaging findings in four patients. AJR 1992; 158: 1329–1332.PubMedGoogle Scholar
  41. 32a.
    Barinaga M. Antibodies linked to rare epilepsy. Science 1995; 268: 362–363.PubMedCrossRefGoogle Scholar
  42. 33.
    Kioumehr F, Dadsetan MR, Rooholamini SA, Au A. Cen¬tral nervous system tuberculosis: MRI. Neuroradiology 1994; 36: 93–96.PubMedCrossRefGoogle Scholar
  43. 34.
    Gupta RK, Gupta S, Singh D, Sharma B, Kohli A, Gujral RB. MR imaging and angiography in tuberculous menin¬gitis. Neuroradiology 1994; 36: 87–92.PubMedCrossRefGoogle Scholar
  44. 35.
    Ulner JL, Elster AD. Sarcoidosis of the central nervous system. Neuroimag Clin North Am 1991; 1 (1): 141–158.Google Scholar
  45. 36.
    Lexa FJ, Grossman RI. MR of sarcoidosis in the head and spine: spectrum of manifestations and radiographic re¬sponse to steroid therapy. AJNR 1994; 15: 973–982.PubMedGoogle Scholar
  46. 37.
    Melhoff KL. Fungal, rickettsial, and parasitic diseases of the nervous system. In: Swaiman KF, ed. Pediatric neurology: principles and practice. St. Louis, C.V. Mosby, 1989, pp. 517–540.Google Scholar
  47. 38.
    Matthews VP, Alo PL, Glass JD, Kumar AJ, McArthur JC. AIDS-related CNS cryptococcosis: radiologicpathologic correlation. AJNR 1992; 13: 1477–1486.Google Scholar
  48. 39.
    Cox J, Murtagh FR, Wilfong A, Brenner J. Cerebral aspergillosis: MR imaging and histopathologic correlation. AJNR 1992; 13: 1489–1492.PubMedGoogle Scholar
  49. 39a.
    Ashdown BC, Tien RD, Felsberg GJ. Aspergillosis of the brain and paranasal sinuses in immunocompromised patients: CT and MR image findings. AJR 1994; 162: 155159.Google Scholar
  50. 40.
    Fellows DW, King VD, Conturo T, Bryan RN, Merz WG, Zinreich SJ. In vitro evaluation of MR hypointensity in Aspergillus colonies. AJNR 1994; 15: 1139–1144.PubMedGoogle Scholar
  51. 41.
    Chang KH, Cho SY. Parasitic diseases of the central nervous system. Neuroimag Clin North Am 1991;1(1):159178.Google Scholar
  52. 42.
    Sharma K, Gupta RK. Scan-negative neurocysticercosis. Pediatr Neurosurg 1993; 19: 206–208.PubMedCrossRefGoogle Scholar
  53. 42a.
    Pittella JE. Neurocysticercosis. Brain Pathol 1997; 7: 68 1693.Google Scholar
  54. 43.
    Ozek MM. Complications of central nervous system hydatid disease. Pediatr Neurosurg 1994; 20: 84–91.PubMedCrossRefGoogle Scholar
  55. 44.
    Peter JC, Domingo Z, Sinclair-Smith C, de Villiers JC. Hydatid infestation of the brain: difficulties with computed tomography diagnosis and surgical treatment. Pediatr Neurosurg 1994; 20: 78–83.PubMedCrossRefGoogle Scholar
  56. 45.
    Demaerel P, Wilms G, Van Lierde S, Delanote J, Baert AL. Lyme disease in childhood presenting as primary leptomeningeal enhancement without parenchymal findings on MR. AJNR 1994; 15: 302–304.PubMedGoogle Scholar
  57. 46.
    Rafto SE, Milton WJ, Galetta SL, Grossman RI. Biopsy-confirmed CNS Lyme disease: MR appearance at 1.5T. AJNR 1990; 11: 482–484.PubMedGoogle Scholar
  58. 47.
    Bale JF, Murph JR. Congenital infections and the nervous system. Pediatr Clin North Am 1992; 39 (4): 669–690.PubMedGoogle Scholar
  59. 48.
    Becker LE. Infections of the developing brain. AJNR 1992; 13: 537–549.PubMedGoogle Scholar
  60. 48a.
    Lane B, Sullivan EV, Lin KO, et al. White matter MR hyperintensities in adult patients with congenital rubella. AJNR 1996; 17: 99.PubMedGoogle Scholar
  61. 49.
    Barkovich AJ, Lindan CE. Congenital cytomegalovirus infection of the brain: imaging analysis and embryologic considerations. AJNR 1994; 15: 703–715.PubMedGoogle Scholar
  62. 50.
    Osborn RE, Byrd SE. Congenital infections of the brain. Neuroimag Clin North Am 1991; 1 (1): 105–118.Google Scholar
  63. 51.
    Friede RL. Infections of the fetus. In: Friede RL, ed. Developmental neuropathology, 2nd ed. Berlin, Springer-Verlag, 1989, pp. 156–168.CrossRefGoogle Scholar
  64. 51a.
    Barkovich AJ, Lindan CE. Congenital cytomegalovirus infection of the brain: imaging analysis and embryologic considerations. AJNR 1994; 15: 703–715.PubMedGoogle Scholar
  65. 52.
    Sklar EML, Post MJD, Lebwohl NH. Imaging of infection of the lumbosacral spine. Neuroimag Clin North Am 1993; 3 (3): 577–590.Google Scholar
  66. 53.
    Bates DJ. Inflammatory diseases of the spine. Neuroimag Clin North Am 1991; 1 (1): 231–250.Google Scholar
  67. 54.
    Colombo N, Berry I, Norman D. Infections of the spine. In: Manelfe C, ed. Imaging of spine and spinal cord. New York, Raven Press, 1992, pp. 489–512.Google Scholar
  68. 55.
    Smith AS, Blaser SI. Infectious and inflammatory processes of the spine. Radiol Clin North Am 1991;29(4):809827.Google Scholar
  69. 56.
    Gero B, Sze G, Sharif H. MR imaging of intradural inflammatory diseases of the spine. AJNR 1991; 12: 1009 1019.Google Scholar
  70. 57.
    Ross JS. Magnetic resonance assessment of the postoperative spine: degenerative disc disease. Radiol Clin North Am 1991; 29 (4): 793–808.PubMedGoogle Scholar
  71. 58.
    Johnson CE, Sze G. Benign lumbar arachnoiditis: MR imaging with Gadopentetate Dimeglumine. AJNR 1990; 11: 763–770.PubMedGoogle Scholar
  72. 59.
    Bell WE, McCormick WF. Guillain-Barré syndrome. In: Bell WE, McCormick WF, eds. Neurologic infections in children. Philadelphia: W.B. Saunders, 1975, pp. 423432.Google Scholar
  73. 60.
    Smith SA. Peripheral neuropathies in children. In: Swaiman KF, ed. Pediatric neurology: principles and practice. St. Louis, C.V. Mosby, 1989, pp. 1105–1123.Google Scholar
  74. 61.
    Georgy BA, Chong B, Chamberlain M, Hesselink JR, Cheung G. MR of the spine in Guillain-Barré syndrome. AJNR 1994; 15: 300–301.PubMedGoogle Scholar
  75. 62.
    Crino PB, Zimmerman RA, Laskowitz D, Raps EC, Rostami AM. Magnetic resonance imaging of the cauda equina in Guillain-Barré syndrome. Neurology 1994; 44: 1334–1336.PubMedCrossRefGoogle Scholar
  76. 63.
    Perry JR, Fung A, Poon P, Bayer N. Magnetic resonance imaging of nerve root inflammation in the Guillain-Barré syndrome. Neuroradiology 1994; 36: 139–140.PubMedCrossRefGoogle Scholar
  77. 64.
    Ropper AH, Poskanzer DC. The prognosis of acute and subacute transverse myelopathy based on early signs and symptoms. Ann Neurol 1978; 4: 51–59.PubMedCrossRefGoogle Scholar
  78. 65.
    Jeffery DR, Mandler RN, Davis LE. Transverse myelitis: retrospective analysis of 33 cases, with differentiation of cases associated with multiple sclerosis and parainfectious events. Arch Neurol 1993; 50: 532–535.PubMedCrossRefGoogle Scholar
  79. 66.
    Campi A, Filippi M, Comi G, et al. Acute transverse myelopathy: spinal and cranial MR study with clinical follow-up. AJNR 1995; 16: 115–123.PubMedGoogle Scholar
  80. 67.
    Kesselring J, Miller DH, Robb SA, et al. Acute disseminated encephalomyelitis: MRI findings and the distinction from multiple sclerosis. Brain 1990; 113: 291–302.PubMedCrossRefGoogle Scholar
  81. 68.
    Berman M, Feldman S, Alter M, Zilber N, Kahana E. Acute transverse myelitis: incidence and etiologic considerations. Neurology 1981; 31: 966–971.PubMedCrossRefGoogle Scholar
  82. 69.
    Tippett DS, Fishman PS, Panitch HS. Relapsing transverse myelitis. Neurology 1991; 41: 703–706.PubMedCrossRefGoogle Scholar
  83. 70.
    Oppenheimer DR. The cervical cord in multiple sclerosis. Neuropathol Appl Neurobiol 1978; 4: 151–162.PubMedCrossRefGoogle Scholar
  84. 71.
    Papadopoulos A, Gatzonis S, Gouliamos A, et al. Correlation between spinal cord MRI and clinical features in patients with demyelinating disease. Neuroradiology 1994; 36: 130–133.PubMedCrossRefGoogle Scholar
  85. 72.
    Ormerod IEC, Miller DH, McDonald WI, et al. The role of NMR imaging in the assessment of multiple sclerosis and isolated neurological lesions. A quantitative study. Brain 1987; 110: 1579–1616.PubMedCrossRefGoogle Scholar
  86. 73.
    Maravilla KR, Weinreb JC, Suss R, Nunnally RL. Magnetic resonance demonstration of multiple sclerosis plaques in the cervical cord. AJR 1985; 144: 381–385.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2000

Authors and Affiliations

  • Nadine Girard
  • Robert A. Zimmerman

There are no affiliations available

Personalised recommendations