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Leptomeningeal contrast enhancement and blood-CSF barrier dysfunction in aseptic meningitis
OBJECTIVE: To investigate the blood-CSF barrier (BCSFB) dysfunction in aseptic meningitis. METHODS: In our case series of 14 patients with acute aseptic meningitis, we compared MRI characteristics with CSF findings. RESULTS: Contrast enhancement in the sulcal space in a leptomeningeal pattern was vi...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Lippincott Williams & Wilkins
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608759/ https://www.ncbi.nlm.nih.gov/pubmed/26516629 http://dx.doi.org/10.1212/NXI.0000000000000164 |
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author | Alonso, Angelika Eisele, Philipp Ebert, Anne D. Griebe, Martin Engelhardt, Britta Szabo, Kristina Hennerici, Michael G. Gass, Achim |
author_facet | Alonso, Angelika Eisele, Philipp Ebert, Anne D. Griebe, Martin Engelhardt, Britta Szabo, Kristina Hennerici, Michael G. Gass, Achim |
author_sort | Alonso, Angelika |
collection | PubMed |
description | OBJECTIVE: To investigate the blood-CSF barrier (BCSFB) dysfunction in aseptic meningitis. METHODS: In our case series of 14 patients with acute aseptic meningitis, we compared MRI characteristics with CSF findings. RESULTS: Contrast enhancement in the sulcal space in a leptomeningeal pattern was visualized in 7 patients with BCSFB dysfunction categorized as moderate to severe as evidenced by the CSF/serum albumin ratio (Q(alb)) but was not present in those with mild or no barrier disturbance (p = 0.001). The Q(alb) as a marker for the leakiness of the BCSFB and, more indirectly, of the blood-brain barrier (BBB) was positively correlated with the incidence of leptomeningeal contrast enhancement seen on postcontrast fluid-attenuated inversion recovery (FLAIR) MRI (p = 0.003). Patients with a more pronounced brain barrier dysfunction recovered more slowly and stayed longer in the hospital. CONCLUSIONS: The severity of meningeal BBB disturbance can be estimated on postcontrast FLAIR MRI, which may be of diagnostic value in patients with aseptic meningitis. |
format | Online Article Text |
id | pubmed-4608759 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-46087592015-10-29 Leptomeningeal contrast enhancement and blood-CSF barrier dysfunction in aseptic meningitis Alonso, Angelika Eisele, Philipp Ebert, Anne D. Griebe, Martin Engelhardt, Britta Szabo, Kristina Hennerici, Michael G. Gass, Achim Neurol Neuroimmunol Neuroinflamm Article OBJECTIVE: To investigate the blood-CSF barrier (BCSFB) dysfunction in aseptic meningitis. METHODS: In our case series of 14 patients with acute aseptic meningitis, we compared MRI characteristics with CSF findings. RESULTS: Contrast enhancement in the sulcal space in a leptomeningeal pattern was visualized in 7 patients with BCSFB dysfunction categorized as moderate to severe as evidenced by the CSF/serum albumin ratio (Q(alb)) but was not present in those with mild or no barrier disturbance (p = 0.001). The Q(alb) as a marker for the leakiness of the BCSFB and, more indirectly, of the blood-brain barrier (BBB) was positively correlated with the incidence of leptomeningeal contrast enhancement seen on postcontrast fluid-attenuated inversion recovery (FLAIR) MRI (p = 0.003). Patients with a more pronounced brain barrier dysfunction recovered more slowly and stayed longer in the hospital. CONCLUSIONS: The severity of meningeal BBB disturbance can be estimated on postcontrast FLAIR MRI, which may be of diagnostic value in patients with aseptic meningitis. Lippincott Williams & Wilkins 2015-10-15 /pmc/articles/PMC4608759/ /pubmed/26516629 http://dx.doi.org/10.1212/NXI.0000000000000164 Text en © 2015 American Academy of Neurology This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially. |
spellingShingle | Article Alonso, Angelika Eisele, Philipp Ebert, Anne D. Griebe, Martin Engelhardt, Britta Szabo, Kristina Hennerici, Michael G. Gass, Achim Leptomeningeal contrast enhancement and blood-CSF barrier dysfunction in aseptic meningitis |
title | Leptomeningeal contrast enhancement and blood-CSF barrier dysfunction in aseptic meningitis |
title_full | Leptomeningeal contrast enhancement and blood-CSF barrier dysfunction in aseptic meningitis |
title_fullStr | Leptomeningeal contrast enhancement and blood-CSF barrier dysfunction in aseptic meningitis |
title_full_unstemmed | Leptomeningeal contrast enhancement and blood-CSF barrier dysfunction in aseptic meningitis |
title_short | Leptomeningeal contrast enhancement and blood-CSF barrier dysfunction in aseptic meningitis |
title_sort | leptomeningeal contrast enhancement and blood-csf barrier dysfunction in aseptic meningitis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608759/ https://www.ncbi.nlm.nih.gov/pubmed/26516629 http://dx.doi.org/10.1212/NXI.0000000000000164 |
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