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Brain Infections 1

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Brain Infections 1

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Brain Infections 1

  1. 1. Infections of the Brain and Meninges Mohamed Samir Assisst. Lecturer
  2. 2. Infections Congenital / Neonatal Acquired • Cytomegalovirus. • Toxoplasmosis. • Rubella. • Herpes Simplex. • HIV Infection. • Enteroviruses. • Meningitis. • Pyogenic Parenchymal Infections. • Encephalitis. • TB & Fungal Infections. • Parasitic Infections.
  3. 3. Congenital/Neonatal Infections
  4. 4. Congenital/Neonatal InfectionsCongenital/Neonatal Infections • Agent: TORCH Toxoplasmosis. Rubella. Cytomegalovirus. Herpes Simplex. HIV Syphilis
  5. 5. Congenital/Neonatal InfectionsCongenital/Neonatal Infections Route of Infection: • Transplacental. • Through birth canal. • Ascending cervical.
  6. 6. Congenital/Neonatal InfectionsCongenital/Neonatal Infections Effects: • Malformations. • Brain Destruction. • Dystrophic calcifications.
  7. 7. Cytomegalovirus I. Congenital/Neonatal Infections Pathology: - Affinity for the developing germinal matrix. - Widespread periventricular necrosis and subsequent dystrophic calcifications. - May cause abnormal neuronal migration.
  8. 8. Cytomegalovirus I. Congenital/Neonatal Infections I. Plain X-Ray: Microcephaly + Eggshell-like periventricular calcifications.
  9. 9. Cytomegalovirus I. Congenital/Neonatal Infections I. Plain X-Ray: Microcephaly + Eggshell-like periventricular calcifications.
  10. 10. Cytomegalovirus I. Congenital/Neonatal Infections  Bilateral periventricular calcifications.  Widespread cerebral destruction and encephalomalasia. II. US:
  11. 11. Cytomegalovirus I. Congenital/Neonatal Infections II. US:
  12. 12. Cytomegalovirus I. Congenital/Neonatal Infections  Atrophy & Ventricular Enlargement.  Periventricular Calcifications.  Neuronal Migration Anomalies. III. CT:
  13. 13. Cytomegalovirus I. Congenital/Neonatal Infections As in CT +  Neuronal Migrational Anomalies.  Delayed Myelination.  Subependymal Paraventricular Cysts & Calcifications. IV. MRI:
  14. 14. Cytomegalovirus I. Congenital/Neonatal Infections IV. MRI:
  15. 15. Cytomegalovirus I. Congenital/Neonatal Infections Associated features:  Hepatosplenomegaly.  Jaundice.  Chorioretinitis.
  16. 16. WHY MEN DIE BEFORE WOMEN!
  17. 17. I. Congenital/Neonatal Infections Toxoplasmosis Pathology:  Triad of: Hydrocephalus, Calcifications and Chorioretinitis.  Multifocal and scattered.  Necrosis & Calcification  No migration anomalies.
  18. 18. I. Congenital/Neonatal Infections Toxoplasmosis I. Plain X-Ray:
  19. 19. I. Congenital/Neonatal Infections Toxoplasmosis II. US:
  20. 20. I. Congenital/Neonatal Infections Toxoplasmosis -Hydrocephalus. - Multiple, irregular, nodular, cyst-like or curvilinear calcifications in the periventricular areas and the choroid plexus. III. CT:
  21. 21. I. Congenital/Neonatal Infections Toxoplasmosis -Hydrocephalus. - Multiple, irregular, nodular, cyst-like or curvilinear calcifications in the periventricular areas and the choroid plexus. III. CT:
  22. 22. I. Congenital/Neonatal Infections Rubella • Pathology: - Inhibits cell proliferation and myelination. - Prominent ocular abnormalities. - Calcifications in basal ganglia and cortex.
  23. 23. I. Congenital/Neonatal Infections Rubella I. Plain X-Ray: - Microcephaly.
  24. 24. I. Congenital/Neonatal Infections Rubella II. US: - Subependymal cysts. Echogenic foci of calcifications.
  25. 25. I. Congenital/Neonatal Infections III. CT: - Microcephaly. - Calcifications in cortex and basal ganglia. Rubella
  26. 26. I. Congenital/Neonatal Infections Rubella IV. MRI: - Deep and sub-cortical lesions. - Delayed myelination.
  27. 27. WHY MEN DIE BEFORE WOMEN!
  28. 28. I. Congenital/Neonatal Infections Herpes Simplex Pathology: - Type 2 in 90%. - Neonatal infection. - Diffuse brain involvement. - Predilection to the endothelial lining of vessels. - No predilection to limbic system.
  29. 29. I. Congenital/Neonatal Infections Herpes Simplex Clinical: - Infants with HSV develop symptoms in the first week of life and typically present at 10-17 days. - Newborns tend to present with 3 patterns, as follows: • Category 1: The disease is limited to the skin, mouth, and eyes. • Category 2: Primary CNS involvement is present. • Category 3: Disseminated disease involving the CNS, lung, liver, skin, and eyes is observed.
  30. 30. I. Congenital/Neonatal Infections Herpes Simplex I. Plain X-Ray: Plain radiographs are not useful in assessing HSV encephalitis.
  31. 31. I. Congenital/Neonatal Infections Herpes Simplex II. CT: - In acute infections, focal or diffuse white matter lucency with accentuated relative hyperdensity of the grey matter. Hemorrhagic infarctions may occur. - Involvement is in the periventricular white matter, sparing the medial temporal and inferior frontal lobes. - In addition, meningeal enhancement may be observed following contrast.
  32. 32. I. Congenital/Neonatal Infections Herpes Simplex III. MRI: - In neonates, Hypointense T1/ Hyperintense T2 lesions in the periventricular white matter, with the medial temporal and inferior frontal lobes spared.
  33. 33. I. Congenital/Neonatal Infections Herpes Simplex III. MRI: - Meningeal enhancement also may be observed.
  34. 34. WHY MEN DIE BEFORE WOMEN!
  35. 35. THANK YOU

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