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Clinico-radiological features of subarachnoid hyperintensity on diffusion-weighted images in patients with meningitis

T Kawaguchi1, K Sakurai, M Hara

  • 1Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. madarafuebuki@yahoo.co.jp

Clinical Radiology
|December 24, 2011
PubMed
Abstract

Insights

Meningitis, both bacterial and fungal, can cause subarachnoid diffusion-weighted imaging (DWI) hyperintensity, often near the frontal lobe. This finding may indicate a poorer prognosis in adult bacterial meningitis cases.

Area of Science:

  • Neurology
  • Radiology
  • Infectious Diseases

Background:

  • Meningitis is a serious infection affecting the brain and spinal cord membranes.
  • Diffusion-weighted imaging (DWI) is a key MRI technique for detecting acute ischemic stroke and other pathologies.

Purpose of the Study:

  • To investigate the clinical and radiological features of meningitis presenting with subarachnoid diffusion-weighted imaging (DWI) hyperintensity.
  • To determine the association between subarachnoid DWI hyperintensity and prognosis in meningitis patients.

Main Methods:

  • Retrospective analysis of 18 patients with meningitis and subarachnoid DWI hyperintensity across five institutions.
  • Evaluation of clinical data, laboratory results, and radiological findings, including lesion location and associated abnormalities.

Main Results:

  • Subarachnoid DWI hyperintensity was observed in 89% of patients, predominantly around the frontal lobe.
  • Bacterial meningitis was most common (15/18 patients), with various pathogens identified.
  • Associated findings included subdural empyema (50%), cerebral infarction (39%), and intraventricular empyema (39%).

Conclusions:

  • Subarachnoid hyperintensity on DWI can be a feature of both bacterial and fungal meningitis, frequently localized to the frontal lobe.
  • This radiological finding is associated with a poorer prognosis in adult patients with bacterial meningitis.

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