Involvement of the Choroid Plexus in Neurotuberculosis: MR Findings in Six Cases

Bhattacharyya, Amrita; Boruah, Deb Kumar; Handique, Akash; Singh, Vivek; Kalita, Jayantee; Misra, Usha Kant; Phadke, RV

doi:10.1177/197140091002300507

Cited by 9 publications

(3 citation statements)

References 10 publications

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“…Adhesions formed between the inflammed ependyma and choroid plexus results in intraventricular septations, ventricular sequestrations, and there by, transependymal seepage of CSF due to obstructed CSF flow. 10,11 Irrespective of the underlying cause, most common MRI finding in ventriculitis is the presence of intraventricular debris and pus on diffusion and FLAIR imaging. Abnormal periventricular and subependymal hyperintensity with enhancement of ventricular wall are the hallmark imaging features; while choroid plexitis is seen as enlarged poorly marginated intensely enhancing choroid plexus on contrast administration.…”

Section: Discussionmentioning

confidence: 99%

Multidrug-Resistant Tubercular Ventriculitis

Kushwaha¹,

Kumari²,

Chaturvedi³

et al. 2022

The Indian Journal of Chest Diseases and Allied Sciences

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Central nervous system tuberculosis accounts for 1% of all tuberculosis cases, and often gets complicated leading to excessive morbidity and mortality. We present a case of a 36-year-old female who presented with tubercular ventriculitis; a rare complication of tuberculous meningitis. Despite prompt clinical diagnosis and appropriate timely management, patient succumbed to the disease. The underlying cause of death could be infection due to multidrugresistant Mycobacterium tuberculosis. This case reinforces the importance of not only early diagnosis of tuberculous meningitis; but also effective anti-tuberculosis therapy following drug susceptibility testing for a favourable outcome.

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Section: Discussionmentioning

confidence: 99%

Multidrug-Resistant Tubercular Ventriculitis

Kushwaha¹,

Kumari²,

Chaturvedi³

et al. 2022

The Indian Journal of Chest Diseases and Allied Sciences

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“…Tuberculomas with solid central caseation appear as hypo-to isointense on both T1 and T2 weighted images with iso-to hyperintense rim on T2WI and peripheral rim-like post-contrast enhancement. On the other hand, intracranial tuberculomas with central liquefaction appear hypointense on T1WI and hyperintense on T2WI with peripheral hypointense rim which shows irregular rim-like peripheral enhancement on the post-contrast study [6,9,12,14,17,18]. Central region of T2 hypointensity is a valuable finding in tuberculoma as it is not found in several other space-occupying lesions [19].In our series, 12 patients (54.5%)of giant tuberculoma demonstrated a central region of T2 hypointensity.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging Appearance of Giant Intracerebral Tuberculoma: A Retrospective Analysis

Boruah

Sarma

Gogoi

et al. 2022

AML

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Background: Giant intracerebral tuberculomas are rare lesions but should be considered in the differential diagnosis of intracranial space-occupying lesion in an endemic region.Objective: The purpose of this study is to analyze the clinical data and magnetic resonance imaging (MRI) findings of giant intracerebral tuberculomas to improve the diagnostic precision.Material and Methods: The clinical and MRI findings of 22 patients of giant intracerebral tuberculoma were analyzed retrospectively. For the statistical analysis independent sample Student t-test was used.Results: For 22 patients included in this sample the giant intracerebral tuberculoma was of size more than 2.5cm. The majority of the giant tuberculomas (19 patients (86.4%))was located in the supratentorial area.T2-weighted hypointense core of giant tuberculoma was observed in 12 patients (54.5%) and T1 hyperintensities were observed in peripheral (wall) of the giant tuberculoma in 14 patients (63.6%). The mean ADC value of the peripheral (wall) of the giant tuberculoma was 1.034± 0.466[SD] x 10-3mm2/s and the core was 0.994± 0.455[SD] x 10-3mm2/s with a statistically significant difference (p-value <0.0005) in between. MR spectroscopy showed raised lipid peak at 0.9 to 1.33 ppm in 10 patients (45.5%),raised lipid-lactate peak in 12 patients (54.5%),raised Choline/Cr ratio more than 1.2 in 14 patients(63.6%) and Choline/Cr ratio less than 1.2 in 5 patients (22.7%). Associated involvement of lung was observed in the 6patients (27.3%), cervical lymph node in 1 patient (4.5%) and spine in 1patient (4.5%).Conclusions: MRI plays a vital role in distinguishing giant intracerebral tuberculomas from other intracranial space-occupying lesions, thereby allows the early institution of anti-tubercular treatment (ATT), decreased patient morbidity, mortality, and prevents unnecessary neurosurgical excision.

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“…Disorders in which ChP volumetric changes have been described span from psychiatric (autism spectrum disorder, psychosis, depression) [18–20] to neurodegenerative (Alzheimer's, Parkinson's) [21,22] and infectious (e.g. CNS cryptococcosis, neurotuberculosis) diseases [23,24]. In the last couple of years, converging results from independent research groups have further demonstrated that ChPs are enlarged in PwMS compared with healthy controls [16 ▪▪ ,25 ▪ ,26 ▪▪ ,27 ▪ ], raising interest on these structures as potential novel MRI biomarker of neuroinflammation [28].…”

Section: In Vivo Analysis Of Choroid Plexuses In Human: the Imaging T...mentioning

confidence: 99%

Choroid plexuses at the interface of peripheral immunity and tissue repair in multiple sclerosis

Ricigliano

Stankoff

2023

Current Opinion in Neurology

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Purpose of reviewChoroid plexuses (ChPs) are key actors of the blood-to-cerebrospinal-fluid barrier and serve as brain immune checkpoint. The past years have seen a regain of interest about their potential involvement in the physiopathology of neuroinflammatory disorders like multiple sclerosis (MS). This article offers an overview of the recent findings on ChP alterations in MS, with a focus on the imaging tools able to detect these abnormalities and on their involvement in inflammation, tissue damage and repair.Recent findingsOn MRI, ChPs are enlarged in people with MS (PwMS) versus healthy individuals. This size increase is an early event, already detected in presymptomatic and pediatric MS. Enlargement of ChPs is linked to local inflammatory infiltrates, and their dysfunction selectively impacts periventricular damage, larger ChPs predicting the expansion of chronic active lesions, smoldering inflammation and remyelination failure in tissues surrounding the ventricles. ChP volumetry may add value for the prediction of disease activity and disability worsening.SummaryChP imaging metrics are emerging as possible biomarkers of neuroinflammation and repair failure in MS. Future works combining multimodal imaging techniques should provide a more refined characterization of ChP functional changes, their link with tissue damage, blood to cerebrospinal-fluid barrier dysfunction and fluid trafficking in MS.

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Involvement of the Choroid Plexus in Neurotuberculosis: MR Findings in Six Cases

Cited by 9 publications

References 10 publications

Multidrug-Resistant Tubercular Ventriculitis

Multidrug-Resistant Tubercular Ventriculitis

Magnetic Resonance Imaging Appearance of Giant Intracerebral Tuberculoma: A Retrospective Analysis

Choroid plexuses at the interface of peripheral immunity and tissue repair in multiple sclerosis

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