leptomeningitis

Bakterielle

Meningitis; T1w-Kernspinaufnahme mit Kontrastmittel

Postcontrast

Fluid-attenuated inversion recovery (FLAIR) MRI of a case of meningitis. It shows the enhancement of meninges at the tentorium and in the parietal region, with evidence of dilated ventricles.

Wikipedia • CC BY 3.0

Teenager with

left orbital and forehead swelling. Sagittal CT with contrast of the brain shows frontal and left maxillary sinusitis and extensive soft tissue swelling anterior to the forehead (upper left) and destruction of the anterior left frontal bone in the frontal sinus and extensive soft tissue swelling anterior to the left orbit (upper right). Coronal (lower left) and sagittal (lower right) T1 MRI with contrast of the brain shows diffuse meningeal enhancement, subdural empyemas along the falx and both cerebral convexities, and multiple large non-enhancing subgaleal fluid collections in the left scalp.The diagnosis was meningitis, subdural empyema, and Pott puffy tumor as complications of sinusitis.

pediatricimaging.org • CC-by-nc-sa 4.0

Leptomeningitis

• Meningitis - Ganzer Fall bei Radiopaedia

Gaillard, F. Meningitis. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-36360 • CC by-nc-sa 3.0 (modified)

Leptomeningitis

• Viral meningitis and papilledema - Ganzer Fall bei Radiopaedia

Gaillard, F. Viral meningitis and papilledema. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-38266 • CC by-nc-sa 3.0 (modified)

Leptomeningitis

• Bacterial meningitis - septation of subarachnoid spaces - Ganzer Fall bei Radiopaedia

Haouimi, A. Bacterial meningitis - septation of subarachnoid spaces. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-97444 • CC by-nc-sa 3.0 (modified)

Leptomeningitis

• Tubercular meningitis with tuberculomas - Ganzer Fall bei Radiopaedia

Jha, P. Tubercular meningitis with tuberculomas. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-8853 • CC by-nc-sa 3.0 (modified)

Leptomeningitis

• Meningitis from mastoiditis resulting in death - Ganzer Fall bei Radiopaedia

Gaillard, F. Meningitis from mastoiditis resulting in death. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-10688 • CC by-nc-sa 3.0 (modified)

CNS

infectious diseases • Cryptococcal meningitis - Ganzer Fall bei Radiopaedia

Greif, E. Cryptococcal meningitis. Case study, Radiopaedia.org. (accessed on 20 Oct 2022) https://doi.org/10.53347/rID-35505 • CC by-nc-sa 3.0 (modified)

Former

premature newborn, now 1 month old with seizures. Coronal US of the brain (above) shows a dilated ventricular system that contains complex echogenic fluid. Axial CT without contrast of the brain (below) shows a dilated ventricular system that contains complex fluid. The diagnosis was meningitis due to E. coli resulting in pus in the ventricular system causing communicating hydrocephalus.

pediatricimaging.org • CC-by-nc-sa 4.0

Ureaplasma

parvum meningitis following atypical choroid plexus papilloma resection in an adult patient: a case report and literature review. A Enhanced preoperative MRI showing a left temporal lobe-lateral ventricle tumor. B CT scans on the first day after surgery demonstrating that the tumor had been removed and replaced with CSF, with the opening of the left lateral ventricles. C Enhanced MRI images on the 43rd day after surgery demonstrating complete tumor resection

bmcinfectdis.biomedcentral.com • CC-by-4.0

Radiopaedia • CC-by-nc-sa 3.0 • de

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
viral meningitis
- Enterovirus
- JC virus meningitis
mycobacterial meningitis
- Mycobacterium tuberculosis
  - tuberculous meningitis
  - tuberculous pachymeningitis
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
- sarcoidosis
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

The complications of meningitis can be remembered using the mnemonic HACTIVE.

leptomeningitis

Pathology

Etiology

Infective

Aseptic meningitis

Radiographic features

CT

MRI

Treatment and prognosis

Complications

See also

Siehe auch:

und weiter: