Skip to main content

Advertisement

SpringerLink
Log in

Cerebral infections

  • Neuro
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Despite the development of many effective antibiotic therapies and the general improvement in hygiene and health care systems all over the world, the incidence of central nervous system (CNS) infection has increased significantly in the past 15 years. This can be attributed primarily to the acquired immunodeficiency syndrome (AIDS) epidemic and its devastating effect on the immune system and secondarily to various immunosuppressive agents that are being used in aggressive cancer treatment and in organ transplantations. The brain particularly is protected from infection by the calvarium, meninges and blood brain barrier. However, different types of pathogens, including bacteria, viruses, fungi and parasites, can reach the brain hematogenously or, less likely, by direct extension from an adjacent infected focus. The early detection and specific diagnosis of infection are of great importance, since brain infections are potentially treatable diseases. Imaging studies play a crucial role in the diagnostic process, along with the history (exposure to infectious agents), host factors (open head trauma, CSF leak, sinusitis, otitis, immune status), physical examination and laboratory analysis of CSF.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Mathisen GE, Johnson JP (1997) Brain abscess. Clin Infect Dis 25(4):763–779

    CAS  PubMed  Google Scholar 

  2. Falcone S, Post MJ (2000) Encephalitis, cerebritis and brain abscess: pathophysiology and imaging findings. Neuroimaging Clin N Am 10(2):333–353

    CAS  PubMed  Google Scholar 

  3. Lai PH, Ho JT, Chen WL et al (2002) Brain abscess and necrotic brain tumor: discrimination with proton MR. Spectroscopy and diffusion-weighted imaging. Am J Neuroradiol 23:1369–1377

    PubMed  Google Scholar 

  4. Burtscher IM, Holtas S (1999) In vivo proton MR spectroscopy of untreated and treated brain abscesses. Am J Neuroradiol 20:1049–1053

    CAS  PubMed  Google Scholar 

  5. Guzman R, Barth A, Lovblad KO et al (2002) Use of diffusion-weighted MRI in differentiating purulent brain processes from cystic brain tumors. J Neurosurg 97(5):1101–1107

    Google Scholar 

  6. Phillips ME, Ryals TJ, Kambhu SA, Vuh WTC (1990) Neoplastic vs. inflammatory meningeal enhancement with Gd-DTPA. J Comput Assist Tomogr 14:536–541

    CAS  PubMed  Google Scholar 

  7. Singer MB, Atlas SW, Drayer BP (1998) Subarachnoid space disease: diagnosis with FLAIR MR imaging and comparison with gadolonium-enhanced spin echo MRI blinded reader study. Radiology 208:417–422

    CAS  PubMed  Google Scholar 

  8. Anslow P (2004) Cranial bacterial infection. Eur Radiol [Suppl 3] 14:E145–E154

  9. Tien RD, Felsberg GJ, Osumi AK (1993) Herpesvirus infections of the CNS: MR findings. Am J Roentgenol 161:167–176

    CAS  Google Scholar 

  10. White ML, Edwards-Brown MK (1995) Fluid attenuated inversion recovery (FLAIR) MRI of herpes encephalitis. J Comput Assist Tomogr 19:501–505

    CAS  PubMed  Google Scholar 

  11. Tsai YD, Chang WN, Shen CC et al (2003) Intracranial suppuration: a clinical comparison of subdural and epidural abscesses. Surg Neurol 59(3):191–196

    Article  PubMed  Google Scholar 

  12. Nathoo N, Nadvi SS, van Deller JR, Gouws E (1999) Intracranial subdural empyemas in the era of computed tomography: a review of 699 cases. Neurosurgery 44(3):529–535

    Google Scholar 

  13. Ramsey DW, Mohammad A, Cherryman GR (2000) Diffusion-weighted imaging of cerebral abscess and subdural empyema. Am J Neuroradiol 21:1172

    PubMed  Google Scholar 

  14. Tsuchiya K, Osawa A, Katase S et al (2003) Diffusion-weighted MRI of subdural and epidural empyemas. Neuroradiology 45:220–223

    CAS  PubMed  Google Scholar 

  15. Del Brutto OH, Sotelo J (1998) Neurocysticercosis: an update. Rev Infect Dis 10:1075–1087

    Google Scholar 

  16. Chang KH, Cho SY, Hesselink JR et al (1991) Parasitic diseases of the central nervous system. Neuroimaging Clin N Am 1:159–178

    Google Scholar 

  17. Gray F, Chretien F, Vallat-Decouvelaere AV, Scaravilli F (2003) The changing pattern of HIV neuropathology in the HAART era. Neuropathol Exp Neurol 62(5):429–440

    Google Scholar 

  18. Lantos PL, Mclaughlin JE, Scholtz CL et al (1989) Neuropathology of the brain in HIV infection. Lancet 1:309–311

    Article  CAS  PubMed  Google Scholar 

  19. Federle MP (1988) A radiologist looks at AIDS: imaging evaluation based on symptom complexes. Radiology 166:553–562

    CAS  PubMed  Google Scholar 

  20. Ramsey RG, Geremia GK (1988) CNS complications of AIDS: CT and MR findings. Am J Roentgenol 151:449–454

    CAS  Google Scholar 

  21. Chang L, Ernst T (1997) MR spectroscopy and diffusion-weighted MRI in focal brain lesions in AIDS. Neuroimaging Clin N Am 7(3):409–426

    CAS  PubMed  Google Scholar 

  22. Ernst TM, Chang L, Witt MD et al (1998) Cerebral toxoplasmosis and lymphoma in AIDS: perfusion MRI experience in 13 patients. Radiology 208:663–669

    CAS  PubMed  Google Scholar 

  23. Andreula CF, Burdi N, Carella A (1993) CNS cryptococcosis in AIDS: spectrum of MR findings. J Comput Assist Tomogr 17:438–441

    CAS  PubMed  Google Scholar 

  24. Shah GV (2000) Central nervous system tuberculosis. Neuroimaging Clin N Am 10(2):355–374

    CAS  PubMed  Google Scholar 

  25. Bernaerts A, Vanhoenacker FM, Parizel PM (2003) Tuberculosis of the central nervous system: overview of neuroradiological findings. Eur Radiol 13:1876–1890

    Article  CAS  PubMed  Google Scholar 

  26. Guermazi A, Gluckman E, Tabt B, Miaux Y (2003) Invasive central nervous system aspergillosis in bone marrow transplantation recipients.: an overview. Eur Radiol 13(2):377–388

    Article  PubMed  Google Scholar 

  27. Moller HE, Vermathen P, Lentsching et al (1999) Metabolic characterization of AIDS dementia complex by spectroscopic imaging. J Magn Reson Imaging 9(1):10–18

    Article  CAS  PubMed  Google Scholar 

  28. Kalayjian RC, Cohen ML, Bonomo RA, Flanigan TP (1993) CMV ventriculoencephalitis in AIDS: a syndrome with distinct clinical and pathologic features. Medicine 72:67–77

    CAS  PubMed  Google Scholar 

  29. Domingo P, Guadiola JM, Iranzo A, Margall N (1997) Remission of prograssive multifocal leukoencephalopathy and antiviral therapy. Lancet 349:1554–1555

    CAS  Google Scholar 

  30. Kotecha N, George MJ, Smith TW et al (1998) Enhancing progressive multifocal leukoencephalopathy: an indicator of improved immune status. Am J Med 105:541–543

    Article  CAS  PubMed  Google Scholar 

  31. Dousset V, Armand JP, Lacoste D et al (1997) Magnetization transfer study of HIV-encephalitis and progressive multifocal leukoencephalopathy. Am J Neuroradiol 18:895–901

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, University of Crete, Stavrakia, 71111, Heraklion, Crete, Greece

    Spyros Karampekios

  2. Department of Radiology, UCSD, San Diego, CA, USA

    John Hesselink

Authors
  1. Spyros Karampekios
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Spyros Karampekios.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Karampekios, S., Hesselink, J. Cerebral infections. Eur Radiol 15, 485–493 (2005). https://doi.org/10.1007/s00330-004-2556-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-004-2556-1

Keywords

Search

Navigation