leptomeningitis
Leptomeningitis, which is more commonly referred to as meningitis, represents inflammation of the subarachnoid space (i.e. arachnoid mater and pia mater) caused by an infectious or noninfectious process.
Pathology
Etiology
Infective
- pyogenic meningitis
- elderly
- Streptococcus pneumoniae
- Listeria monocytogenes
- Neisseria meningitidis
- Gram negative bacilli
- adults
- Streptococcus pneumoniae
- Neisseria meningitidis
- Group B streptococcus
- children
- Neisseria meningitidis
- infants
- Streptococcus pneumoniae
- Neisseria meningitidis
- neonates
- Group B streptococcus
- Escherichia coli
- Listeria monocytogenes
- elderly
- viral meningitis
- Enterovirus
- JC virus meningitis
- mycobacterial meningitis
- Mycobacterium tuberculosis
- fungal meningitis
- Cryptococcus neoformans (in patients with AIDS)
- Coccidioides immitis
For a further discussion related to other etiological agents and other infective processes in the CNS, please refer to CNS infectious diseases.
Aseptic meningitis
- leptomeningeal carcinomatosis
- rheumatoid arthritis
- granulomatous
- iatrogenic
- postoperative
- hydrogel-coated aneurysm coils
Radiographic features
CT
- may be normal
- subtle hydrocephalus
- hyperdensity around basal cisterns (especially in tuberculosis)
- leptomeningeal enhancement
- complications or sources of the meningitis
MRI
- T1: may be normal; sulci may appear less hypointense than normal
- T1 C+ (Gd): leptomeningeal enhancement
- FLAIR: demonstrates hyperintense signal in CSF space, especially in the sulci
- FLAIR C+ (Gd): has shown to be more sensitive and specific than T1 C+ (Gd) sequence in spotting leptomeningeal enhancement
- MR angiography: arterial narrowing or occlusion
Treatment and prognosis
Complications
- hydrocephalus
- subdural empyema
- epidural empyema
- cerebritis and cerebral abscess
- infarction
- ventriculitis
- dural sinus thrombosis
The complications of meningitis can be remembered using the mnemonic HACTIVE.
See also
Siehe auch:
- Hydrocephalus
- ventriculitis
- Sarkoidose
- Tuberkulose des ZNS
- Abszess
- Meningeosis neoplastica
- meningeale Tuberkulose
- Sinusthrombose
- bakterielle Meningitis
- Liquorunterdrucksyndrom
- Pneumokokkenmeningitis
- leptomeningeale Kontrastmittelanreicherungen
- Meningitis Ultraschall
- Cryptococcus neoformans
und weiter:
- Apicitis petrosa
- neuroradiology curriculum
- communicating hydrocephalus
- Verschlusshydrocephalus
- meningoencephalitis
- subdurales Hygrom
- verdickter Hypophysenstiel
- Gradenigo-Syndrom
- subarachnoid FLAIR hyperintensity
- subdurales Empyem
- akute Otomastoiditis
- Mondini-Dysplasie
- pott puffy tumour
- akute Sinusitis
- intraspinale zystische Läsionen
- BBB
- Normaldruckhydrozephalus
- Ependymitis
- meningeale Kontrastmittelaufnahme
- intrakranielle Infektionen
- chronisch adhäsive Arachnopathie
- communicating obstructive hydrocephalus
- Aquäduktstenose
- meningeale Kryptokokkose
- multizystische Encephalopathie nach Meningitis
- Orbitabodenfraktur
- hemophilus influenza B meningitis
- Temporallappenepilepsie
- group B streptococcus meningitis
- ependymal enhancement
- diffusion MRI of acute cerebral infarction following meningitis
- brudzinski sign
