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Intracranial Infection

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Pediatric Neuroimaging
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Abstract

Intracranial inflammatory disorders are common in children, including infection and immune-associated encephalitis. Common intracranial infectious encephalitis pathogens include bacteria, viruses, fungi, tuberculosis, parasites, and other pathogens. Immune-associated encephalitis is becoming more common due to its underlying abnormal immune response in the central nervous system. Some immune-associated encephalitis are associated with antibodies against cell surface antigens, which include NMDAR, MOG, AQP4, etc. CT and MRI examinations can assist clinicians to determine the location and extent of the lesions, follow up the evolution of the lesions, find out the complications, observe the treatment effect, and give a qualitative diagnosis in certain cases. MRI is much more effective than CT and has become the preferred method for the examination of inflammatory disorders in children.

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References

  1. Neuberger I, Garcia J, Meyers ML, et al. Imaging of congenital central nervous system infections. Pediatr Radiol. 2018;48(4):513–23. https://doi.org/10.1007/s00247-018-4092-1.

    Article  PubMed  Google Scholar 

  2. de Vries LS. Viral infections and the neonatal brain. Semin Pediatr Neurol. 2019;32:100769. https://doi.org/10.1016/j.spen.2019.08.005.

    Article  PubMed  Google Scholar 

  3. Soares de Oliveira-Szejnfeld P, Levine D, Melo AS, et al. Congenital brain abnormalities and Zika virus: what the radiologist can expect to see prenatally and postnatally. Radiology. 2016;281(1):203–18. https://doi.org/10.1148/radiol.2016161584.

    Article  PubMed  Google Scholar 

  4. Abdel-Salam GMH, Abdel-Hamid MS, Mohammad SA, et al. Aicardi-Goutieres syndrome: unusual neuro-radiological manifestations. Metab Brain Dis. 2017;32(3):679–83. https://doi.org/10.1007/s11011-017-9993-4.

    Article  PubMed  Google Scholar 

  5. Goncalves FG, Caschera L, Teixeira SR, et al. Intracranial calcifications in childhood: part 1. Pediatr Radiol. 2020;50(10):1424–47. https://doi.org/10.1007/s00247-020-04721-1.

    Article  PubMed  Google Scholar 

  6. Goncalves FG, Caschera L, Teixeira SR, et al. Intracranial calcifications in childhood: part 2. Pediatr Radiol. 2020;50(10):1448–75. https://doi.org/10.1007/s00247-020-04716-y.

    Article  PubMed  Google Scholar 

  7. Bale JF. Fetal infections and brain development. Clin Perinatol. 2009;36(3):639–53. https://doi.org/10.1016/j.clp.2009.06.005.

    Article  PubMed  Google Scholar 

  8. Nickerson JP, Richner B, Santy K, et al. Neuroimaging of pediatric intracranial infection—part 2: TORCH, viral, fungal, and parasitic infections. J Neuroimaging. 2012;22(2):e52–63. https://doi.org/10.1111/j.1552-6569.2011.00699.x.

    Article  PubMed  Google Scholar 

  9. Ai J, Xie Z, Liu G, et al. Etiology and prognosis of acute viral encephalitis and meningitis in Chinese children: a multicentre prospective study. BMC Infect Dis. 2017;17(1):494. https://doi.org/10.1186/s12879-017-2572-9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Shah G. Neuroimaging clinics of North America. Central nervous system infections. Preface. Neuroimaging Clin N Am. 2012;22(4):xiii. https://doi.org/10.1016/j.nic.2012.08.001.

    Article  PubMed  Google Scholar 

  11. Rath TJ, Hughes M, Arabi M, et al. Imaging of cerebritis, encephalitis, and brain abscess. Neuroimaging Clin N Am. 2012;22(4):585–607. https://doi.org/10.1016/j.nic.2012.04.002.

    Article  PubMed  Google Scholar 

  12. Misra UK, Kalita J, Phadke RV, et al. Usefulness of various MRI sequences in the diagnosis of viral encephalitis. Acta Trop. 2010;116(3):206–11. https://doi.org/10.1016/j.actatropica.2010.08.007.

    Article  CAS  PubMed  Google Scholar 

  13. Sarma A, Heck JM, Bhatia A, et al. Magnetic resonance imaging of the brainstem in children, part 2: acquired pathology of the pediatric brainstem. Pediatr Radiol. 2021;51(2):189–204. https://doi.org/10.1007/s00247-020-04954-0.

    Article  PubMed  Google Scholar 

  14. Quattrocchi CC, Longo D, Delfino LN, et al. MR differential diagnosis of acute deep grey matter pathology in paediatric patients. Pediatr Radiol. 2013;43(6):743–61. https://doi.org/10.1007/s00247-012-2491-2.

    Article  PubMed  Google Scholar 

  15. World Health Organization. Global tuberculosis report 2020. 2020.

    Google Scholar 

  16. Kritsaneepaiboon S, Andres MM, Tatco VR, et al. Extrapulmonary involvement in pediatric tuberculosis. Pediatr Radiol. 2017;47(10):1249–59. https://doi.org/10.1007/s00247-017-3867-0.

    Article  PubMed  Google Scholar 

  17. Holmberg PJ, Temesgen Z, Banerjee R. Tuberculosis in children. Pediatr Rev. 2019;40(4):168–78. https://doi.org/10.1542/pir.2018-0093.

    Article  PubMed  Google Scholar 

  18. Wang DM, Li QF, Zhu M, et al. Epidemiological, clinical characteristics and drug resistance situation of culture-confirmed children TBM in southwest of China: a 6-year retrospective study. BMC Infect Dis. 2020;20(1):318. https://doi.org/10.1186/s12879-020-05041-3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Chaudhary V, Bano S, Garga UC. Central nervous system tuberculosis: an imaging perspective. Can Assoc Radiol J. 2017;68(2):161–70. https://doi.org/10.1016/j.carj.2016.10.007.

    Article  PubMed  Google Scholar 

  20. Nickerson JP, Richner B, Santy K, et al. Neuroimaging of pediatric intracranial infection—part 1: techniques and bacterial infections. J Neuroimaging. 2012;22(2):e42–51. https://doi.org/10.1111/j.1552-6569.2011.00700.x.

    Article  PubMed  Google Scholar 

  21. Swinburne NC, Bansal AG, Aggarwal A, et al. Neuroimaging in central nervous system infections. Curr Neurol Neurosci Rep. 2017;17(6):49. https://doi.org/10.1007/s11910-017-0756-8.

    Article  CAS  PubMed  Google Scholar 

  22. Azeemuddin M, Alvi A, Sayani R, et al. Neuroimaging findings in tuberculosis: a single-center experience in 559 cases. J Neuroimaging. 2019;29(5):657–68. https://doi.org/10.1111/jon.12627.

    Article  PubMed  Google Scholar 

  23. Schaller MA, Wicke F, Foerch C, et al. Central nervous system tuberculosis : etiology, clinical manifestations and Neuroradiological features. Clin Neuroradiol. 2019;29(1):3–18. https://doi.org/10.1007/s00062-018-0726-9.

    Article  PubMed  Google Scholar 

  24. Parmar H, Ibrahim M. Pediatric intracranial infections. Neuroimaging Clin N Am. 2012;22(4):707–25. https://doi.org/10.1016/j.nic.2012.05.016.

    Article  PubMed  Google Scholar 

  25. Shih RY, Koeller KK. Bacterial, fungal, and parasitic infections of the central nervous system: radiologic-pathologic correlation and historical perspectives. Radiographics. 2015;35(4):1141–69. https://doi.org/10.1148/rg.2015140317.

    Article  PubMed  Google Scholar 

  26. Muccio CF, Caranci F, D’Arco F, et al. Magnetic resonance features of pyogenic brain abscesses and differential diagnosis using morphological and functional imaging studies: a pictorial essay. J Neuroradiol. 2014;41(3):153–67. https://doi.org/10.1016/j.neurad.2014.05.004.

    Article  PubMed  Google Scholar 

  27. Reddy DS, Volkmer R 2nd. Neurocysticercosis as an infectious acquired epilepsy worldwide. Seizure. 2017;52:176–81. https://doi.org/10.1016/j.seizure.2017.10.004.

    Article  PubMed  Google Scholar 

  28. Garcia HH, Del Brutto OH. Cysticercosis working group in P. Neurocysticercosis: updated concepts about an old disease. Lancet Neurol. 2005;4(10):653–61. https://doi.org/10.1016/S1474-4422(05)70194-0.

    Article  PubMed  Google Scholar 

  29. Siddiqua T, Habeeb A. Neurocysticercosis. Saudi J Kidney Dis Transpl. 2020;31(1):254–8. https://doi.org/10.4103/1319-2442.279948.

    Article  PubMed  Google Scholar 

  30. Gupta MM, Chaudhary N, Pathak S, et al. Neurocysticercosis in children with seizures: a cross-sectional study. Int J Pediatr. 2018;2018:1030878. https://doi.org/10.1155/2018/1030878.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Kufel J. Pathological structural changes in the brain in the course of neurocysticercosis—pathogenesis, serological diagnostics and imaging: a literature review. Ann Parasitol. 2020;66(4):441–6. https://doi.org/10.17420/ap6604.284.

    Article  PubMed  Google Scholar 

  32. Chou IJ, Wang HS, Whitehouse WP, et al. Paediatric multiple sclerosis: update on diagnostic criteria, imaging, histopathology and treatment choices. Curr Neurol Neurosci Rep. 2016;16(7):68. https://doi.org/10.1007/s11910-016-0663-4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Otallah S, Banwell B. Pediatric multiple sclerosis: an update. Curr Neurol Neurosci Rep. 2018;18(11):76. https://doi.org/10.1007/s11910-018-0886-7.

    Article  PubMed  Google Scholar 

  34. Ruet A. Update on pediatric-onset multiple sclerosis. Rev Neurol (Paris). 2018;174(6):398–407. https://doi.org/10.1016/j.neurol.2018.04.003.

    Article  CAS  Google Scholar 

  35. McGinley MP, Goldschmidt CH, Rae-Grant AD. Diagnosis and treatment of multiple sclerosis: a review. JAMA. 2021;325(8):765–79. https://doi.org/10.1001/jama.2020.26858.

    Article  CAS  PubMed  Google Scholar 

  36. Fadda G, Armangue T, Hacohen Y, et al. Paediatric multiple sclerosis and antibody-associated demyelination: clinical, imaging, and biological considerations for diagnosis and care. Lancet Neurol. 2021;20(2):136–49. https://doi.org/10.1016/S1474-4422(20)30432-4.

    Article  CAS  PubMed  Google Scholar 

  37. Alroughani R, Boyko A. Pediatric multiple sclerosis: a review. BMC Neurol. 2018;18(1):27. https://doi.org/10.1186/s12883-018-1026-3.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Dalmau J, Armangue T, Planaguma J, et al. An update on anti-NMDA receptor encephalitis for neurologists and psychiatrists: mechanisms and models. Lancet Neurol. 2019;18(11):1045–57. https://doi.org/10.1016/S1474-4422(19)30244-3.

    Article  CAS  PubMed  Google Scholar 

  39. Scheer S, John RM. Anti-N-methyl-D-aspartate receptor encephalitis in children and adolescents. J Pediatr Health Care. 2016;30(4):347–58. https://doi.org/10.1016/j.pedhc.2015.09.004.

    Article  PubMed  Google Scholar 

  40. Kayser MS, Titulaer MJ, Gresa-Arribas N, et al. Frequency and characteristics of isolated psychiatric episodes in anti-N-methyl-d-aspartate receptor encephalitis. JAMA Neurol. 2013;70(9):1133–9. https://doi.org/10.1001/jamaneurol.2013.3216.

    Article  PubMed  Google Scholar 

  41. Dalmau J, Graus F. Antibody-mediated encephalitis. N Engl J Med. 2018;378(9):840–51. https://doi.org/10.1056/NEJMra1708712.

    Article  PubMed  Google Scholar 

  42. Titulaer MJ, Hoftberger R, Iizuka T, et al. Overlapping demyelinating syndromes and anti-N-methyl-D-aspartate receptor encephalitis. Ann Neurol. 2014;75(3):411–28. https://doi.org/10.1002/ana.24117.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Zhang T, Duan Y, Ye J, et al. Brain MRI characteristics of patients with anti-N-methyl-D-aspartate receptor encephalitis and their associations with 2-year clinical outcome. AJNR Am J Neuroradiol. 2018;39(5):824–9. https://doi.org/10.3174/ajnr.A5593.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Bartels F, Krohn S, Nikolaus M, et al. Clinical and magnetic resonance imaging outcome predictors in pediatric anti-N-methyl-D-aspartate receptor encephalitis. Ann Neurol. 2020;88(1):148–59. https://doi.org/10.1002/ana.25754.

    Article  CAS  PubMed  Google Scholar 

  45. Sarbu N, Shih RY, Jones RV, et al. White matter diseases with radiologic-pathologic correlation. Radiographics. 2016;36(5):1426–47. https://doi.org/10.1148/rg.2016160031.

    Article  PubMed  Google Scholar 

  46. Gray MP, Gorelick MH. Acute disseminated encephalomyelitis. Pediatr Emerg Care. 2016;32(6):395–400. https://doi.org/10.1097/PEC.0000000000000825.

    Article  PubMed  Google Scholar 

  47. Nishiyama M, Nagase H, Tomioka K, et al. Clinical time course of pediatric acute disseminated encephalomyelitis. Brain and Development. 2019;41(6):531–7. https://doi.org/10.1016/j.braindev.2019.02.011.

    Article  PubMed  Google Scholar 

  48. Anilkumar AC, Foris LA, Tadi P. Acute disseminated encephalomyelitis. Treasure Island, FL: StatPearls; 2021.

    Google Scholar 

  49. Pohl D, Alper G, Van Haren K, et al. Acute disseminated encephalomyelitis: updates on an inflammatory CNS syndrome. Neurology. 2016;87(9 Suppl 2):S38–45. https://doi.org/10.1212/WNL.0000000000002825.

    Article  PubMed  Google Scholar 

  50. Frampton JE. Eculizumab: a review in neuromyelitis optica spectrum disorder. Drugs. 2020;80(7):719–27. https://doi.org/10.1007/s40265-020-01297-w.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Paolilo RB, Deiva K, Neuteboom R, et al. Acute disseminated encephalomyelitis: current perspectives. Children (Basel). 2020;7(11) https://doi.org/10.3390/children7110210.

  52. Malagon VJ. [Demyelinizing diseases in children. Acute disseminated encephalomyelitis and multiple sclerosis]. Medicina (B Aires). 2019;79(Suppl 3): 66–70.

    Google Scholar 

  53. Santoro JD, Chitnis T. Diagnostic considerations in acute disseminated encephalomyelitis and the interface with MOG antibody. Neuropediatrics. 2019;50(5):273–9. https://doi.org/10.1055/s-0039-1693152.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Gombolay GY, Chitnis T. Pediatric neuromyelitis optica spectrum disorders. Curr Treat Options Neurol. 2018;20(6):19. https://doi.org/10.1007/s11940-018-0502-9.

    Article  PubMed  Google Scholar 

  55. Ungureanu A, de Seze J, Ahle G, et al. Myelin oligodendrocyte glycoprotein antibodies in neuromyelitis optica spectrum disorder. Rev Neurol (Paris). 2018;174(10):675–9. https://doi.org/10.1016/j.neurol.2018.01.378.

    Article  CAS  Google Scholar 

  56. Dutra BG, da Rocha AJ, Nunes RH, et al. Neuromyelitis optica spectrum disorders: spectrum of MR imaging findings and their differential diagnosis. Radiographics. 2018;38(1):169–93. https://doi.org/10.1148/rg.2018170141.

    Article  PubMed  Google Scholar 

  57. Kim HJ, Paul F, Lana-Peixoto MA, et al. MRI characteristics of neuromyelitis optica spectrum disorder: an international update. Neurology. 2015;84(11):1165–73. https://doi.org/10.1212/WNL.0000000000001367.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Kim SM, Kim SJ, Lee HJ, et al. Differential diagnosis of neuromyelitis optica spectrum disorders. Ther Adv Neurol Disord. 2017;10(7):265–89. https://doi.org/10.1177/1756285617709723.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Wang LJ, Kong DZ, Guo ZN, et al. Study on the clinical, imaging, and pathological characteristics of 18 cases with primary central nervous system vasculitis. J Stroke Cerebrovasc Dis. 2019;28(4):920–8. https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.12.007.

    Article  PubMed  Google Scholar 

  60. Elbers J, Armstrong D, Yau I, et al. Vascular imaging outcomes of childhood primary angiitis of the central nervous system. Pediatr Neurol. 2016;63:53–9. https://doi.org/10.1016/j.pediatrneurol.2016.06.009.

    Article  PubMed  Google Scholar 

  61. Smitka M, Bruck N, Engellandt K, et al. Clinical perspective on primary angiitis of the central nervous system in childhood (cPACNS). Front Pediatr. 2020;3(8):281. https://doi.org/10.3389/fped.2020.00281.

    Article  Google Scholar 

  62. Deb-Chatterji M, Schuster S, Haeussler V, et al. Primary angiitis of the central nervous system: new potential imaging techniques and biomarkers in blood and cerebrospinal fluid. Front Neurol. 2019;6(10):568. https://doi.org/10.3389/fneur.2019.00568.

    Article  Google Scholar 

  63. Fullerton HJ, Wu YW, Sidney S, et al. Risk of recurrent childhood arterial ischemic stroke in a population based cohort: the importance of cerebrovascular imaging. Pediatrics. 2007;119:495–501. https://doi.org/10.1542/peds.2006-2791.

    Article  PubMed  Google Scholar 

  64. Wangchun D, Hongsheng L, Jianming L, et al. Imaging findings of childhood primary angiitis of the central nervous system. Chin J Radiol. 2020;54(7):713–5. https://doi.org/10.3760/cma.j.cn112149-20190627-00531.

    Article  Google Scholar 

  65. Kumar RS, Singh A, Rathore C, et al. Primary angiitis of central nervous system: tumor-like lesion. Neurol India. 2010;58:147–9. https://doi.org/10.4103/0028-3886.60417.

    Article  PubMed  Google Scholar 

  66. Press C, Wallace A, Chapman KE. The Janus-faced nature of Rasmussen’s encephalitis. Semin Pediatr Neurol. 2014;21(2):129–36. https://doi.org/10.1016/j.spen.2014.04.018.

    Article  PubMed  Google Scholar 

  67. Tang C, Luan G, Li T. Rasmussen’s encephalitis: mechanisms update and potential therapy target. Ther Adv Chronic Dis. 2020;11:2040622320971413. https://doi.org/10.1177/2040622320971413.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Cay-Martinez KC, Hickman RA, McKhann Ii GM, et al. Rasmussen encephalitis: an update. Semin Neurol. 2020;40(2):201–10. https://doi.org/10.1055/s-0040-1708504.

    Article  PubMed  Google Scholar 

  69. David B, Prillwitz CC, Hoppe C, et al. Morphometric MRI findings challenge the concept of the “unaffected” hemisphere in Rasmussen encephalitis. Epilepsia. 2019;60(5):e40–6. https://doi.org/10.1111/epi.14702.

    Article  PubMed  Google Scholar 

  70. Zhao DJ, Zhu MW, Du TQ, et al. MRI diagnosis of Rasmussen encephalitis. Chinese J Radiol. 2012;4(46)

    Google Scholar 

  71. Wellard RM, Briellmann RS, Wilson JC, et al. Longitudinal study of MRS metabolites in Rasmussen encephalitis. Brain. 2004;127(Pt 6):1302–12. https://doi.org/10.1093/brain/awh157.

    Article  CAS  PubMed  Google Scholar 

  72. Tessonnier L, Thomas P, Benisvy D, et al. Perfusion SPECT findings in a suspected case of Rasmussen encephalitis. J Neuroimaging. 2009;19(4):378–80. https://doi.org/10.1111/j.1552-6569.2008.00320.x.

    Article  PubMed  Google Scholar 

  73. Wagner J, Schoene-Bake JC, Bien CG, et al. Automated 3D MRI volumetry reveals regional atrophy differences in Rasmussen encephalitis. Epilepsia. 2012;53(4):613–21. https://doi.org/10.1111/j.1528-1167.2011.03396.x.

    Article  PubMed  Google Scholar 

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Li, X., Zhang, M., Zheng, G., Li, X., Chen, J. (2022). Intracranial Infection. In: Liu, H., Zhang, X. (eds) Pediatric Neuroimaging. Springer, Singapore. https://doi.org/10.1007/978-981-16-7928-5_3

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