Leptomeningeal enhancement - meningitis

Case contributed by Emmanouil Kalioras , 15 Jul 2022
Diagnosis almost certain
Changed by Emmanouil Kalioras, 18 Jul 2022

Updates to Case Attributes

Status changed from draft to pending review.
Body was changed:

After CSF analysis, clinicians favoured the diagnosis of viral meningitis and patient received antiviral therapy. 2 weeks followup was negative for leptomeningeal enhancement.

The sensitivity of contrast enhanced FLAIR sequences is remarkably higher in comparison to contrast enhanced T1-weighted sequences for the imaging diagnosis of meningitis. The main reason is the better distinction between enhacingenhancing meninges and enhancing cortical veins. The signal of contrast enhanced cortical veins is attenuated only on FLAIR images.

  • -<p>After CSF analysis clinicians favoured the diagnosis of viral meningitis and patient received antiviral therapy. 2 weeks followup was negative for leptomeningeal enhancement.</p><p>The sensitivity of contrast enhanced FLAIR sequences is remarkably higher in comparison to contrast enhanced T1-weighted sequences for the diagnosis of meningitis. The main reason is the better distinction between enhacing meninges and enhancing cortical veins. The signal of contrast enhanced cortical veins is attenuated only on FLAIR images.</p><p> </p><p> </p><p> </p>
  • +<p>After CSF analysis, clinicians favoured the diagnosis of viral meningitis and patient received antiviral therapy. 2 weeks followup was negative for leptomeningeal enhancement.</p><p>The sensitivity of contrast enhanced FLAIR sequences is remarkably higher in comparison to contrast enhanced T1-weighted sequences for the imaging diagnosis of meningitis. The main reason is the better distinction between enhancing meninges and enhancing cortical veins. The signal of contrast enhanced cortical veins is attenuated only on FLAIR images.</p><p> </p><p> </p><p> </p>

Updates to Study Attributes

Findings was changed:

Leptomeningeal enhancement has resolved.

CorticalThe signal of an enhancing cortical vein attenuation around the left parietal lobe has failed appearinghasn't been attenuated, appearing as a T2 hyperintensity on post-contrast FLAIR images (artifact).

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