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Alonso A, Eisele P, Ebert AD, et al. Leptomeningeal contrast enhancement and blood-CSF barrier dysfunction in aseptic meningitis. Neurol Neuroimmunol Neuroinflamm. 2015;2(6):e164doi: 10.1212/NXI.0000000000000164.
Alonso, A., Eisele, P., Ebert, A. D., Griebe, M., Engelhardt, B., Szabo, K., Hennerici, M. G., & Gass, A. (2015). Leptomeningeal contrast enhancement and blood-CSF barrier dysfunction in aseptic meningitis. Neurology(R) neuroimmunology & neuroinflammation, 2(6), e164. https://doi.org/10.1212/NXI.0000000000000164
Alonso, Angelika, et al. "Leptomeningeal contrast enhancement and blood-CSF barrier dysfunction in aseptic meningitis." Neurology(R) neuroimmunology & neuroinflammation vol. 2,6 (2015): e164. doi: https://doi.org/10.1212/NXI.0000000000000164
Alonso A, Eisele P, Ebert AD, Griebe M, Engelhardt B, Szabo K, Hennerici MG, Gass A. Leptomeningeal contrast enhancement and blood-CSF barrier dysfunction in aseptic meningitis. Neurol Neuroimmunol Neuroinflamm. 2015 Oct 15;2(6):e164. doi: 10.1212/NXI.0000000000000164. eCollection 2015 Dec. PMID: 26516629; PMCID: PMC4608759.
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Neurol Neuroimmunol Neuroinflamm. 2015 Oct 15;2(6):e164. doi: 10.1212/NXI.0000000000000164. eCollection 2015 Dec.

Leptomeningeal contrast enhancement and blood-CSF barrier dysfunction in aseptic meningitis.

Neurology(R) neuroimmunology & neuroinflammation

Angelika Alonso, Philipp Eisele, Anne D Ebert, Martin Griebe, Britta Engelhardt, Kristina Szabo, Michael G Hennerici, Achim Gass

Affiliations

  1. Department of Neurology (A.A., P.E., A.D.E., M.G., K.S., M.G.H., A.G.), Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany; and Theodor Kocher Institute (B.E.), University of Bern, Bern, Switzerland.

PMID: 26516629 PMCID: PMC4608759 DOI: 10.1212/NXI.0000000000000164

Abstract

OBJECTIVE: To investigate the blood-CSF barrier (BCSFB) dysfunction in aseptic meningitis.

METHODS: In our case series of 14 patients with acute aseptic meningitis, we compared MRI characteristics with CSF findings.

RESULTS: Contrast enhancement in the sulcal space in a leptomeningeal pattern was visualized in 7 patients with BCSFB dysfunction categorized as moderate to severe as evidenced by the CSF/serum albumin ratio (Qalb) but was not present in those with mild or no barrier disturbance (p = 0.001). The Qalb as a marker for the leakiness of the BCSFB and, more indirectly, of the blood-brain barrier (BBB) was positively correlated with the incidence of leptomeningeal contrast enhancement seen on postcontrast fluid-attenuated inversion recovery (FLAIR) MRI (p = 0.003). Patients with a more pronounced brain barrier dysfunction recovered more slowly and stayed longer in the hospital.

CONCLUSIONS: The severity of meningeal BBB disturbance can be estimated on postcontrast FLAIR MRI, which may be of diagnostic value in patients with aseptic meningitis.

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