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CT of intracranial cryptococcosis
M J Popovich1, R H Arthur, E Helmer
1Department of Diagnostic Imaging, Kaiser Foundation Hospital, Los Angeles, CA 90027.
AJR. American Journal of Roentgenology
|March 1, 1990
Summary
CT scans reveal that many intracranial cryptococcal infections present normally. However, abnormal findings like diffuse atrophy or mass lesions warrant consideration for cryptococcosis in at-risk patients.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Intracranial cryptococcosis is a serious opportunistic infection.
- Accurate and timely diagnosis is crucial for effective treatment.
Observation:
- Retrospective review of CT scans from 35 patients with intracranial cryptococcal infection.
- Analysis of CT findings including normal scans, diffuse atrophy, mass lesions (cryptococcoma), hydrocephalus, and cerebral edema.
Findings:
- 43% of CT scans were normal, highlighting a diagnostic challenge.
- Abnormal findings were nonspecific, including diffuse atrophy (34%), cryptococcoma (11%), hydrocephalus (9%), and cerebral edema (3%).
- Unusual cryptococcoma presentations like gelatinous pseudocysts and intraventricular cysts were observed.
Implications:
- Consider central nervous system (CNS) cryptococcosis in at-risk patients with these nonspecific CT findings, irrespective of clinical presentation.
- Magnetic Resonance (MR) imaging may aid in detecting cryptococcal mass lesions, such as gelatinous pseudocysts, not visible on CT.