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

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Theodor Kocher Institute

UniBE Contributor:

Engelhardt, Britta

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2332-7812

Publisher:

Wolters Kluwer Health

Language:

English

Submitter:

Ursula Zingg-Zünd

Date Deposited:

14 Mar 2016 15:21

Last Modified:

14 Mar 2016 15:21

Publisher DOI:

10.1212/NXI.0000000000000164

PubMed ID:

26516629

BORIS DOI:

10.7892/boris.77196

URI:

https://boris.unibe.ch/id/eprint/77196

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