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Semin Neurol 2008; 28(4): 511-522
DOI: 10.1055/s-0028-1083688
© Thieme Medical Publishers

Neuroimaging of Infections of the Central Nervous System

Oliver Kastrup1 , Isabel Wanke2 , Matthias Maschke3
  • 1Department of Neurology, University Duisburg-Essen, Germany
  • 2Department of Neuroradiology, University Duisburg-Essen, Germany
  • 3Department of Neurology and Neurophysiology, Brüderkrankenhaus Trier, Germany
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Publication History

Publication Date:
08 October 2008 (online)

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ABSTRACT

Neuroimaging plays a crucial role in the diagnosis and therapeutic management of neurologic infections. This article summarizes imaging findings in brain abscesses, ventriculitis, viral diseases, and opportunistic infections. In cases of uncomplicated meningitis, cranial computed tomography is sufficient to exclude brain edema, hydrocephalus, and skull base pathology. Magnetic resonance imaging (MRI) is superior in depicting complications (e.g., empyema, vasculitis). Diffusion-weighted imaging (DWI) shows parenchymal complications of meningitis earlier and is of help in differentiation of pyogenic abscess from other ring-enhancing lesions. Proton magnetic resonance spectroscopy can produce specific peak-patterns in cases of abscess, such as the presence of lactate and cytosolic amino acids. In toxoplasmosis, DWI may help to differentiate from lymphoma, showing no restriction of water diffusion. In patients with viral encephalitis, DWI allows earlier lesion detection. MRI has revolutionized the rapid diagnosis of spinal abscess.

KEYWORDS

Neuroimaging - infections - therapy - MRI - diffusion-weighted imaging

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Oliver KastrupM.D. 

Department of Neurology, Universität Duisburg-Essen

Hufelandstr. 55, 45122 Essen, Germany

Email: oliver.kastrup@uni-due.de

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