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Frequency of unexplained meningeal enhancement in the brain after lumbar puncture

R L Mittl1, D M Yousem

  • 1Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.

Abstract

Insights

Lumbar puncture rarely causes meningeal enhancement in the brain. This enhancement, if present, is typically due to other factors and should be considered a rare diagnosis of exclusion.

Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Meningeal enhancement on brain MRI can be caused by various conditions.
  • The potential for lumbar puncture to induce meningeal enhancement is debated.

Purpose of the Study:

  • To investigate whether lumbar puncture (LP) alone can cause meningeal enhancement in brain Magnetic Resonance Imaging (MRI).

Main Methods:

  • Prospective review of brain MRI examinations within one month post-lumbar puncture.
  • Retrospective review of dural-arachnoidal enhancement cases over an 18-month period.

Main Results:

  • In the prospective cohort (97 patients), only one case showed unexplained dural-arachnoidal enhancement post-LP.
  • In the retrospective cohort (11 cases), only one enhancement was not clearly explained.

Conclusions:

  • Dural-arachnoidal enhancement following lumbar puncture is an infrequent occurrence.
  • Lumbar puncture as a cause of meningeal enhancement is a rare diagnosis of exclusion.

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