Acute Pediatric Encephalitis Neuroimaging: Single-Institution Series as Part of the California Encephalitis Project

Bykowski, Julie; Kruk, Peter; Gold, Jeffrey J.; Glaser, Carol; Sheriff, Heather; Crawford, John R.

doi:10.1016/j.pediatrneurol.2015.02.024

Cited by 21 publications

(29 citation statements)

References 39 publications

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“…MRI may improve the sensitivity for detecting encephalitis, as T2 FLAIR is sensitive for vasogenic edema, diffusion-weighted imaging is sensitive for cytotoxic edema, and postcontrast T1 and T2 FLAIR sequences are sensitive for meningeal enhancement. The combination of MRI sequences can be very helpful to exclude mimics of encephalitis, identify the extent of inflammation, and confirm if lesion distribution is concordant with symptoms [52]. The distribution of abnormalities on MRI can help guide in determining the pathogen in some cases.…”

Section: Variant 3: Child Sudden Severe Headache (Thunderclap Headacmentioning

confidence: 99%

“…For instance, brain stem and spinal cord involvement is common with enterovirus, and basal ganglia/thalamic involvement is common with West Nile virus or Japanese encephalitis. It is important to note that the classic limbic distribution of herpes simplex virus-1 may not always be present, and that extratemporal involvement is not uncommon [52].…”

Section: Variant 3: Child Sudden Severe Headache (Thunderclap Headacmentioning

confidence: 99%

“…Neurologic signs and symptoms such as nuchal rigidity or alteration in consciousness may be indications for imaging with CT. However, the sensitivity of CT in diagnosing pediatric encephalitis in comparison with MRI is generally poor [52]. In the emergency setting, CT may be indicated in evaluating children with suspected intracranial infection, often performed before lumbar puncture.…”

Section: Variant 3: Child Sudden Severe Headache (Thunderclap Headacmentioning

confidence: 99%

“…A negative noncontrast CT scan of the head should not conclude the evaluation for suspected encephalitis. In a study by Bykowski et al [52], cranial CT was the initial study in 94 patients, and abnormal findings were present in 22. An additional 26 children had normal acute CT results and abnormal findings identified on MRI performed within 2 days [52].…”

Section: Variant 3: Child Sudden Severe Headache (Thunderclap Headacmentioning

confidence: 99%

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ACR Appropriateness Criteria ® Headache–Child

Hayes

Palasis

Bartel

et al. 2018

Journal of the American College of Radiology

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Headaches in children are not uncommon and have various causes. Proper neuroimaging of these children is very specific to the headache type. Care must be taken to choose and perform the most appropriate initial imaging examination in order to maximize the ability to properly determine the cause with minimum risk to the child. This evidence-based report discusses the different headache types in children and provides appropriate guidelines for imaging these children. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

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Section: Variant 3: Child Sudden Severe Headache (Thunderclap Headacmentioning

confidence: 99%

Section: Variant 3: Child Sudden Severe Headache (Thunderclap Headacmentioning

confidence: 99%

Section: Variant 3: Child Sudden Severe Headache (Thunderclap Headacmentioning

confidence: 99%

Section: Variant 3: Child Sudden Severe Headache (Thunderclap Headacmentioning

confidence: 99%

See 2 more Smart Citations

ACR Appropriateness Criteria ® Headache–Child

Hayes

Palasis

Bartel

et al. 2018

Journal of the American College of Radiology

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“…La identificación radiológica del realce lepto-meníngeo encontrado en un paciente hace parte de los hallazgos reportados en las neuroimágenes de los pacientes con meningitis viral. Estos relacionan al EV con una distribución típica hacia el tronco encefálico y la medula espinal (9).…”

Section: Discussionunclassified

Meningitis por enterovirus: un reporte de casos en la región del Oriente de Antioquia, Colombia

2019

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Meningitis viral meningitis bacteriana antibióticos técnicas de diagnóstico molecular enterovirus RESUMEN Antecedentes Los enterovirus son la principal causa de meningitis infecciosa en la edad pediátrica. Hacer la diferenciación por clínica y laboratorio entre las diversas etiologías infecciosas resulta impreciso.Resumen del caso En este estudio realizamos la descripción de 13 pacientes pediátricos que ingresaron a nuestra institución con un cuadro clínico compatible con meningitis y en quienes se realizó detección de enterovirus en líquido cefalorraquídeo mediante técnicas moleculares.Conclusiones A través de métodos como la detección de enterovirus en el líquido cefalorraquídeo, puede obtenerse el diagnóstico de meningitis viral de forma rápida, disminuyendo el uso de antibiótico y la estancia hospitalaria.

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Medical Imaging of CNS Infection

Shen

2020

Diagnostic Neuroradiology

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For mild meningitis, CT and MRI often have no finding or only show mild hydrocephalus. For bacterial meningitis, CT and MRI may show leptomeningeal enhancement and mild hydrocephalus. Some cases have exudate in the basal cistern, and some cases are associated with arterial or venous infarctions. Some cases are also associated with brain abscess or subdural empyema. CT and MRI can clearly show these complications. Brain abscesses reveal ring enhancement with severe peripheral white matter edema in CT and MRI. DWI and MRS are helpful for differential diagnosis of brain abscess with tumor necrosis. MRI is better than CT to detect encephalitis, showing hyperintensity on T2WI and FLAIR. In some instances, the affected brain tissue has diffusion restriction, indicating hyperintensity on DWI, and some have contrast enhancement because of BBB disruption. Central nervous system (CNS) infections include meningitis (Figs. 7.1-7.10), brain abscess (Figs. 7.7, 7.11-7.17), epidural and subdural empyema (Fig. 7.7), encephalitis (Figs. 7.18-7.25), and meningoencephalitis (Figs. 7.6, 7.9, and 7.25). Besides, CNS infections may involve the spinal cord and spinal canal, namely encephalomyelitis and meningoencephalomyelitis. CNS infection pathogenesis includes the virus, bacteria, fungus (Figs. 7.3 and 7.6), and parasites (Fig. 7.17). Some cases of CNS infections involve post-infectious encephalitis, such as acute disseminated encephalomyelitis (ADEM) (Figs. 7.26 and 7.27). However, the pathogen of numerous CNS infection cases has yet to be revealed (Fig. 7.5).

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Acute Pediatric Encephalitis Neuroimaging: Single-Institution Series as Part of the California Encephalitis Project

Cited by 21 publications

References 39 publications

ACR Appropriateness Criteria ® Headache–Child

ACR Appropriateness Criteria ® Headache–Child

Meningitis por enterovirus: un reporte de casos en la región del Oriente de Antioquia, Colombia

Medical Imaging of CNS Infection

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