Neuroimaging clinics of North America
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Infections of the spine represent a rare but potentially debilitating and neurologically devastating condition for patients. Early diagnosis, imaging, and intervention may prevent some of the more critical complications that may ensue from this disease process, including alignment abnormalities, central canal compromise, nerve root impingement, vascular complications, and spinal cord injury. This article reviews the underlying pathophysiologic basis of infection, clinical manifestations, and imaging modalities used to diagnose infections of the spine and spinal cord.
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Central nervous system infections account for 1% of primary hospital admissions and 2% of nosocomial infections and when encountered require prompt diagnosis and initiation of specific treatment. Imaging findings are mostly nonspecific with respect to the causative pathogen. This article describes the anatomy of cranial meninges and extra-axial spaces of the brain. Characteristic findings and recent advances in neuroimaging of meningitis and its complications and ventriculitis are summarized, and certain noninfectious causes of meningitis and meningitis mimics are described.
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Neurocysticercosis (NCC) is an infection of the central nervous system by the Taenia solium larvae, and is the most common cause of acquired epilepsy in endemic regions. The natural history of parenchymal NCC lesions can be divided into 4 stages with unique imaging and clinical features. Evaluation of cysticerci is challenging on conventional magnetic resonance (MR) imaging and computed tomography, and is significantly improved with MR cysternography techniques. Differentiation of NCC lesions from metastatic disease and pyogenic abscesses can be improved with advanced MR imaging including (1)H nuclear MR spectroscopy, diffusion-weighted imaging, and MR perfusion imaging.
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Radiology provides valuable gross pathologic information about central nervous system (CNS) infections. Major categories of infectious lesions of the brain and spinal cord are recognized by imaging such as diffuse, focal, or multifocal. ⋯ It illustrates examples with gross and microscopic photographs of CNS infections, and the tissue reactions to these infections. Where the organism can spread within the CNS, and cellular responses to the organism underlie both the radiographic and pathologic findings.
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Neuroimaging Clin. N. Am. · Nov 2012
ReviewNeurosurgical aspects of central nervous system infections.
Infections of the central nervous system (CNS) can be severe, disabling, and potentially fatal. Infections of the central nervous system (CNS) can be severe, disabling, and potentially fatal. Appropriate recognition of symptoms facilitates expeditious evaluation, prompt diagnosis, and timely treatment. ⋯ This review explores the presentation, pathogenesis, evaluation, and treatment of the most common infections of the CNS. Discussion of treatment options also includes possible neurosurgical interventions. The infections considered are cerebral abscess, subdural empyema, meningitis, encephalitis, toxoplasmosis, neurocysticercosis, diskitis, and spinal epidural abscess.