Skip to main content
SpringerLink
Log in

Imaging of Brain Infections

  • Reference work entry
  • First Online:
Atlas of Emergency Imaging from Head-to-Toe

  • 1659 Accesses

Abstract

Infections of the central nervous system are potentially treatable emergencies. Imaging plays a central role in the early diagnosis of brain infections and in the detection of related complications, in patients presenting to the ED. While many organisms share non-specific and overlapping manifestations, others have characteristic imaging findings that may allow a prompt confident diagnosis. We describe the manifestations and imaging appearance of the most common acquired acute pyogenic, viral, mycobacterial, fungal, and parasitic infections which may lead to a neurological emergency. Acute opportunistic infections in patients with acquired immunodeficiency syndrome (AIDS) will also be described.

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 899.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 649.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hughes DC, Raghavan A, Mordekar SR, Griffiths PD, Connolly DJ. Role of imaging in the diagnosis of acute bacterial meningitis and its complications. Postgrad Med J. 2010;86(1018):478–85.

    Article  CAS  PubMed  Google Scholar 

  2. Brouwer MC, Thwaites GE, Tunkel AR, van de Beek D. Dilemmas in the diagnosis of acute community-acquired bacterial meningitis. Lancet. 2012;380(9854):1684–92.

    Article  PubMed  Google Scholar 

  3. 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.

    Article  PubMed  Google Scholar 

  4. Azad R, Tayal M, Azad S, Sharma G, Srivastava RK. Qualitative and quantitative comparison of contrast-enhanced fluid-attenuated inversion recovery, magnetization transfer spin echo, and fat-saturation T1-weighted sequences in infectious meningitis. Korean J Radiol. 2017;18(6):973–82.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Kanamalla US, Ibarra RA, Jinkins JR. Imaging of cranial meningitis and ventriculitis. Neuroimaging Clin N Am. 2000;10(2):309–31.

    CAS  PubMed  Google Scholar 

  6. Helweg-Larsen J, Astradsson A, Richhall H, Erdal J, Laursen A, Brennum J. Pyogenic brain abscess, a 15 year survey. BMC Infect Dis. 2012;12:332.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Rath TJ, Hughes M, Arabi M, Shah GV. Imaging of cerebritis, encephalitis, and brain abscess. Neuroimaging Clin N Am. 2012;22(4):585–607.

    Article  PubMed  Google Scholar 

  8. Toh CH, Wei KC, Chang CN, et al. Differentiation of pyogenic brain abscesses from necrotic glioblastomas with use of susceptibility-weighted imaging. AJNR Am J Neuroradiol. 2012;33(8):1534–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Luthra G, Parihar A, Nath K, et al. Comparative evaluation of fungal, tubercular, and pyogenic brain abscesses with conventional and diffusion MR imaging and proton MR spectroscopy. AJNR Am J Neuroradiol. 2007;28(7):1332–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Gupta RK, Jobanputra KJ, Yadav A. MR spectroscopy in brain infections. Neuroimaging Clin N Am. 2013;23(3):475–98.

    Article  PubMed  Google Scholar 

  11. Fujikawa A, Tsuchiya K, Honya K, Nitatori T. Comparison of MRI sequences to detect ventriculitis. AJR Am J Roentgenol. 2006;187(4):1048–53.

    Article  PubMed  Google Scholar 

  12. de Noordhout CM, Devleesschauwer B, Angulo FJ, et al. The global burden of listeriosis: a systematic review and meta-analysis. Lancet Infect Dis. 2014;14(11):1073–82.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Drevets DA, Bronze MS. Listeria monocytogenes: epidemiology, human disease, and mechanisms of brain invasion. FEMS Immunol Med Microbiol. 2008;53(2):151–65.

    Article  CAS  PubMed  Google Scholar 

  14. Carmo RLD, Alves Simao AK, Amaral L, et al. Neuroimaging of emergent and reemergent infections. Radiographics. 2019;39(6):1649–71.

    Article  PubMed  Google Scholar 

  15. Soares BP, Provenzale JM. Imaging of herpesvirus infections of the CNS. AJR Am J Roentgenol. 2016;206(1):39–48.

    Article  PubMed  Google Scholar 

  16. Bradshaw MJ, Venkatesan A. Herpes simplex virus-1 encephalitis in adults: pathophysiology, diagnosis, and management. Neurotherapeutics. 2016;13(3):493–508.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Cag Y, Erdem H, Leib S, et al. Managing atypical and typical herpetic central nervous system infections: results of a multinational study. Clin Microbiol Infect. 2016;22(6):568.e569–17.

    Article  Google Scholar 

  18. Colpitts TM, Conway MJ, Montgomery RR, Fikrig E. West Nile virus: biology, transmission, and human infection. Clin Microbiol Rev. 2012;25(4):635–48.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Tyler KL. West Nile virus infection in the United States. Arch Neurol. 2004;61(8):1190–5.

    Article  PubMed  Google Scholar 

  20. Ali M, Safriel Y, Sohi J, Llave A, Weathers S. West Nile virus infection: MR imaging findings in the nervous system. AJNR Am J Neuroradiol. 2005;26(2):289–97.

    PubMed  PubMed Central  Google Scholar 

  21. Torres C, Riascos R, Figueroa R, Gupta RK. Central nervous system tuberculosis. Top Magn Reson Imaging. 2014;23(3):173–89.

    Article  PubMed  Google Scholar 

  22. Dastur DK, Manghani DK, Udani PM. Pathology and pathogenetic mechanisms in neurotuberculosis. Radiol Clin North Am. 1995;33(4):733–52.

    CAS  PubMed  Google Scholar 

  23. Jongeling AC, Pisapia D. Pearls and oy-sters: tuberculous meningitis: not a diagnosis of exclusion. Neurology. 2013;80(4):e36–9.

    Article  PubMed  Google Scholar 

  24. Gupta RK, Kumar S. Central nervous system tuberculosis. Neuroimaging Clin N Am. 2011;21(4):795–814, vii–viii

    Article  PubMed  Google Scholar 

  25. Helmy A, Antoun N, Hutchinson P. Cerebral tuberculoma and magnetic resonance imaging. J R Soc Med. 2011;104(7):299–301.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Gupta RK, Kohli A, Gaur V, Lal JH, Kishore J. MRI of the brain in patients with miliary pulmonary tuberculosis without symptoms or signs of central nervous system involvement. Neuroradiology. 1997;39(10):699–704.

    Article  CAS  PubMed  Google Scholar 

  27. Jinkins JR, Gupta R, Chang KH, Rodriguez-Carbajal J. MR imaging of central nervous system tuberculosis. Radiol Clin North Am. 1995;33(4):771–86.

    CAS  PubMed  Google Scholar 

  28. RK G. Tuberculosis and other non-tuberculous bacterial granulomatous infections. In: RK G, RB L, editor. MR imaging and spectroscopy of central nervous system infection. New York: Kluwer Academic/Plenum Publishers; 2001. p. 95–145.

    Google Scholar 

  29. Sundaram C, Umabala P, Laxmi V, et al. Pathology of fungal infections of the central nervous system: 17 years’ experience from Southern India. Histopathology. 2006;49(4):396–405.

    Article  CAS  PubMed  Google Scholar 

  30. Gavito-Higuera J, Mullins CB, Ramos-Duran L, Olivas Chacon CI, Hakim N, Palacios E. Fungal infections of the central nervous system: a pictorial review. J Clin Imag Sci. 2016;6:24.

    Article  Google Scholar 

  31. Mathur M, Johnson CE, Sze G. Fungal infections of the central nervous system. Neuroimaging Clin N Am. 2012;22(4):609–32.

    Article  PubMed  Google Scholar 

  32. Yousem DM, Galetta SL, Gusnard DA, Goldberg HI. MR findings in rhinocerebral mucormycosis. J Comput Assist Tomogr. 1989;13(5):878–82.

    Article  CAS  PubMed  Google Scholar 

  33. Keyik B, Edguer T, Hekimoglu B. Conventional and diffusion-weighted MR imaging of cerebral aspergillosis. Diagn Interv Radiol. 2005;11(4):199–201.

    PubMed  Google Scholar 

  34. Hurst RW, Judkins A, Bolger W, Chu A, Loevner LA. Mycotic aneurysm and cerebral infarction resulting from fungal sinusitis: imaging and pathologic correlation. AJNR Am J Neuroradiol. 2001;22(5):858–63.

    CAS  PubMed  PubMed Central  Google Scholar 

  35. Kimura-Hayama ET, Higuera JA, Corona-Cedillo R, et al. Neurocysticercosis: radiologic-pathologic correlation. RadioGraphics. 2010;30(6):1705–19.

    Article  PubMed  Google Scholar 

  36. Zhao J-L, Lerner A, Shu Z, Gao X-J, Zee C-S. Imaging spectrum of neurocysticercosis. Radiol Infect Dis. 2015;1(2):94–102.

    Article  Google Scholar 

  37. Garcia HH, Nash TE, Del Brutto OH. Clinical symptoms, diagnosis, and treatment of neurocysticercosis. Lancet Neurol. 2014;13(12):1202–15.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Lucato LT, Guedes MS, Sato JR, Bacheschi LA, Machado LR, Leite CC. The role of conventional MR imaging sequences in the evaluation of neurocysticercosis: impact on characterization of the scolex and lesion burden. Am J Neuroradiol. 2007;28(8):1501.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Bowen LN, Smith B, Reich D, Quezado M, Nath A. HIV-associated opportunistic CNS infections: pathophysiology, diagnosis and treatment. Nat Rev Neurol. 2016;12(11):662–74.

    Article  CAS  PubMed  Google Scholar 

  40. Tan IL, Smith BR, von Geldern G, Mateen FJ, McArthur JC. HIV-associated opportunistic infections of the CNS. Lancet Neurol. 2012;11(7):605–17.

    Article  PubMed  Google Scholar 

  41. Smith AB, Smirniotopoulos JG, Rushing EJ. From the archives of the AFIP: central nervous system infections associated with human immunodeficiency virus infection: radiologic-pathologic correlation. Radiographics. 2008;28(7):2033–58.

    Article  PubMed  Google Scholar 

  42. Akgoz A, Mukundan S, Lee TC. Imaging of rickettsial, spirochetal, and parasitic infections. Neuroimaging Clin N Am. 2012;22(4):633–57.

    Article  PubMed  Google Scholar 

  43. Rumboldt Z, Thurnher MM, Gupta RK. Central nervous system infections. Semin Roentgenol. 2007;42(2):62–91.

    Article  PubMed  Google Scholar 

  44. Swinburne NC, Bansal AG, Aggarwal A, Doshi AH. Neuroimaging in central nervous system infections. Curr Neurol Neurosci Rep. 2017;17(6):49.

    Article  PubMed  CAS  Google Scholar 

  45. da Cunha Correia C, Ramos Lacerda H, de Assis Costa VM, Mertens de Queiroz Brainer A. Cerebral toxoplasmosis: unusual MRI findings. Clin Imaging. 2012;36(5):462–5.

    Article  PubMed  Google Scholar 

  46. Brightbill TC, Post MJ, Hensley GT, Ruiz A. MR of Toxoplasma encephalitis: signal characteristics on T2-weighted images and pathologic correlation. J Comput Assist Tomogr. 1996;20(3):417–22.

    Article  CAS  PubMed  Google Scholar 

  47. Kumar GG, Mahadevan A, Guruprasad AS, et al. Eccentric target sign in cerebral toxoplasmosis: neuropathological correlate to the imaging feature. J Magn Reson Imaging. 2010;31(6):1469–72.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Vachha B, Moonis G, Holodny A. Infections of the brain and meninges. Semin Roentgenol. 2017;52(1):2–9.

    Article  PubMed  Google Scholar 

  49. Goralska K, Blaszkowska J, Dzikowiec M. Neuroinfections caused by fungi. Infection. 2018;46(4):443–59.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Division of Neuroradiology, University of Ottawa, Ottawa, ON, Canada

    Nader Zakhari, Shivaprakash Hiremath, Paulo Puac, Angela Guarnizo & Carlos Torres

  2. Department of Radiology, University of Michigan, Ann Arbor, MI, USA

    Francisco Rivas-Rodriguez

Authors
  1. Nader Zakhari
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shivaprakash Hiremath
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paulo Puac
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Angela Guarnizo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Francisco Rivas-Rodriguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Carlos Torres
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nader Zakhari .

Editor information

Editors and Affiliations

  1. Department of Radiology, McMaster University, Hamilton, ON, Canada

    Michael N. Patlas

  2. NYU Langone Hospital - Long Island and the NYU Long Island School of Medicine, Mineola, NY, USA

    Douglas S. Katz

  3. Department of Medical, Surgical and Experimental Sciences, University of Medicine and Surgery, Sassari, Italy

    Mariano Scaglione

Section Editor information

  1. Department of Diagnostic Imaging, Ottawa Hospital Research Institute OHRI, Ottawa, Ontario, Canada

    Carlos Torres The author is already on the author list. He just has an additional affiliation

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Zakhari, N., Hiremath, S., Puac, P., Guarnizo, A., Rivas-Rodriguez, F., Torres, C. (2022). Imaging of Brain Infections. In: Patlas, M.N., Katz, D.S., Scaglione, M. (eds) Atlas of Emergency Imaging from Head-to-Toe. Springer, Cham. https://doi.org/10.1007/978-3-030-92111-8_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-92111-8_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-92110-1

  • Online ISBN: 978-3-030-92111-8

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation