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 (2015). Leptomeningeal contrast enhancement and blood-CSF barrier dysfunction in aseptic meningitis. Neurology: Neuroimmunology and Neuroinflammation, 2(6), e164. Wolters Kluwer Health 10.1212/NXI.0000000000000164

Preview

Text NEURIMMINFL2015005678.pdf - Published Version Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND). Download (429kB) | Preview

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 (Qalb) but was not present in those with mild or no barrier disturbance (p = 0.001). The Qalb 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.

Interest & Impact

Downloads

559 since deposited on 14 Mar 2016
36 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item