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Multiple sclerosis (MS) is the most frequent idiopathic inflammatory demyelinating disease of the central nervous system. Magnetic resonance imaging is the most important paraclinical parameter in the diagnosis of MS. If the MR criteria for dissemination in time and space are positive, the early diagnosis of MS may be established already after one clinical event; thus, MRI has an important impact...
Vasculitis is defined as inflammation of blood vessels with or without necrosis of the vessel wall. Vasculitis can be further classified based on the origin of vessel pathology into immunoallergic, infectious and neoplastic forms, and divided into primary and secondary subtypes. To confirm the diagnosis, histology is usually required. Vasculitis may involve vessels of both the peripheral and central...
Despite essential proceedings in diagnosis and therapy during the past decades, pyogenic cerebritis and brain abscesses remain severe, potentially life-threatening diseases of the CNS that should be diagnosed without delay. The spectrum of pathogens differs considerably depending on the route of infection, on the one hand, and the status of the immune system of the host, on the other. In addition...
Since 1980 the incidence of syphilis has continuously increased. In the same way also an increase of neurolues is registered. Treponema pallidum, the causative agent of neurolues affects in stage III the central nervous system. Neurolues can take a serious course with a granulomatous or vasculitis form. Magnetic resonance imaging is able to detect both forms, but mostly usually allows no specific...
Tuberculosis is still one of the leading causes of death worldwide: one third of the world population is believed to be infected with Mycobacterium tuberculosis. Neurotuberculosis, which affects mainly young patients, is considered the most dangerous complication as it often leads to severe neurological sequelae or death. The clinical presentation of neurotuberculosis can be quite variable and laboratory...
This chapter focuses on a number of rare bacterial infections that affect the central nervous system. The most common manifestations as well as the characteristic features of these infectious processes, as displayed on imaging studies, are stressed.
With the exception of herpes simplex virus encephalitis type 1 involving preferentially limbic structures of the brain the imaging features of viral encephalitis are mostly unspecific. Typical features of viral encephalitis are vasogenic brain oedema and swelling, variable contrast enhancement of the involved structures, and possibly haemorrhage. The major task of the neuroradiologist is to differentiate...
Sporadic and variant Creutzfeldt-Jakob disease (CJD), as the most important spongiform encephalopathies, are fatal neurodegenerative disorders caused by infectious proteins called prions which aggregate, accumulate and induce neuronal death and spongiform changes of the brain. Definite diagnosis of sporadic CJD (sCJD) requires biopsy, and clinical diagnosis is based on typical clinical symptoms associated...
The manifestations of fungal infections result in life-threatening conditions and the major role of the neuroradiologist is to recognize the manifestation and make an educated guess as to the type of pathogen. Magnetic resonance imaging is the imaging modality of choice, and administration of gadolinium contrast is essential to identify areas of enhancement that may be subtle. In principle, fungal...
The wording “parasite” originates from the ancient Greek “parasitos” (pará = besides, sítos = eating). Parasites are organisms living in (endoparasites, intracellular parasites) or on (ectoparasites) other species (host). The host provides nutrients for the parasite and is injured by the parasite. The relationship between host and parasite is “antagonistic” in favor of the parasite. Detrimental effects...
Neuroimaging is of major importance in all cases of suspected infectious meningitis in order to get quick information about the extent of the disease, typical lesion patterns, and potential complications, such as hydrocephalus, involvement of the underlying brain parenchyma, or vasculitis. In bacterial meningitis, abnormal and asymmetrical enhancement of the leptomeninges and the subarachnoid space...
Granulomatous diseases of the central nervous system include a variety of different syndromes which are defined by focal inflammation containing fused and non-fused granulomas. Depending on the disease, different anatomical structures are affected. In many cases MRI shows characteristic pattern of lesions and allows a specific diagnosis or a very specific differential diagnosis.
Infectious diseases in childhood can be acquired in utero, neonatally or during childhood and adolescence. Classic congenital, i.e. in-utero-acquired, and neonatal infections are summarized in the so-called TORCH group, which stand for TOxoplasmosis, Rubella, Cytomegalovirus and Herpes simplex virus (HSV) type II. These congenital or neonatal infections have a characteristic imaging appearance that...
Different protocols for MR imaging and spectroscopy are presented as well as special imaging features of inflammatory diseases of the cerebral parenchyma as described in this book. Advanced MR techniques, such as DWI, PerfMRI, DTI, MT, as well as MRS, and their use in inflammatory diseases of the cerebral parenchyma, are presented.
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