NEUROIMAGING OF BACTERIAL-MENINGITIS

Managing simple bacterial meningitis is usually done without neuroradi ological investigation. CT scanning is not always required before a lu mbar puncture. In the case of a worsening status, magnetic resonance i maging (MRI) is more accurate than CT scanning for an early diagnosis of complication such as: cerebritis and abscess, empyemas and vascular involvement, and especially thrombosis of venous sinuses which requir es antithrombotic therapy and needs prompt recognition. MRT and magnet ic resonance angiography detect all the potential complications of men ingitis, including venous sinus thrombosis, which is otherwise diagnos ed with a CT-scan and an angiography. Most recurrent meningitis are du e to a fistula between the subarachnoid space and facial sinuses or ea r cavities. In most cases, a CT-scan with direct coronal thin slices r eveals the osteodural defect, whatever the cause, acquired or congenit al. MRI is useful only to assess meningoencephalocele and dermal sinus tract.