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01-09-2009 | Neuro

MR imaging of the posterior hypophysis in children with tuberculous meningitis

Authors: Savvas Andronikou, Ronald van Toorn, Els Boerhout

Published in: European Radiology | Issue 9/2009

Abstract

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) contributes to the morbidity and mortality in children with tuberculous meningitis (TBM). MRI assists in the early diagnosis of TBM and absence of the normal posterior pituitary bright spot (PPS) on T1-weighted MRI in TBM may indicate the functional integrity of the posterior hypophysis. The objective of this retrospective descriptive study of 22 children with TBM was to determine the prevalence of an absent PPS on T1-weighted MRI in children with TBM and its correlation with serum sodium levels (hyponatremia), severity of disease at presentation, and developmental outcome after 6 months. The prevalence of absent PPS in children with TBM was 55%. No significant correlation was found between the PPS and serum sodium status (p = 0.41) or severity of disease at presentation (p = 0.104). There was however a correlation between absent PPS and poorer developmental outcome at 6-month follow-up (p = 0.027).

Fujisawa I, Nishimura K, Asato R, Togashi K, Itoh K, Noma S, Kawamura Y, Sago T, Minami S, Nakano Y et al (1987) Posterior lobe of the pituitary in diabetes insipidus: MR findings. J Comput Assist Tomogr 11:221–225PubMed

Argyropoulou MI, Kiortsis DN (2005) MRI of the hypothalamic-pituitary axis in children. Pediatr Radiol 35:1045–1055PubMedCrossRef

Ozata M, Tayfun D, Kurtaran K et al (1997) Magnetic resonance imaging of posterior pituitary for evaluation of the neurohypophyseal function in idiopathic and autosomal dominant neurohypophyseal diabetes insipidus. Eur Radiol 7:1098–1102PubMedCrossRef

Neville K, Pereira JK (2004) Transient reduction in the posterior pituitary bright signal preceding water intoxication in a malnourished child. J Pediatr Endocrinol Metab 17:1245–1249PubMed

Bergland RM, Ray BS, Torack RM (1968) Anatomical variations in the pituitary gland and adjacent structures in 225 human autopsy cases. J Neurosurg 28:93–99PubMedCrossRef

Bonneville F, Cattin F, Marsot-Dupuch K, Dormont D, Bonneville JF, Chiras J (2006) T1 signal hyperintensity in the sellar region: spectrum of findings. Radiographics 26:93–113PubMedCrossRef

Colombo N, Berry I, Kucharczyk J, Kucharczyk W, de Groot J, Larson T, Norman D, Newton TH (1987) Posterior pituitary gland: appearance on MR images in normal and pathologic states. Radiology 165:481–485PubMed

Palmer BF (2003) Hyponatremia in patients with central nervous system disease: SIADH versus CSW. Trends Endocrinol Metab 14:182–187PubMedCrossRef

Sterns RH, Silver SM (2008) Cerebral salt wasting versus SIADH: what difference? J Am Soc Nephrol 19:194–196PubMedCrossRef

10.

Brimioulle S, Orellana-Jimenez C, Aminian A, Vincent JL (2008) Hyponatremia in neurological patients: cerebral salt wasting versus inappropriate antidiuretic hormone secretion. Intensive Care Med 34:125–131PubMedCrossRef

11.

Maconochie IK, Baumer JH, Stewart M (2008) Fluid therapy for acute bacterial meningitis. Cochrane Libr, Issue 4

12.

Andronikou S, Smith B, Hatherhill M, Douis H, Wilmshurst J (2004) Definitive neuroradiological diagnostic features of tuberculous meningitis in children. Pediatr Radiol 34:876–885PubMedCrossRef

13.

Andronikou S, Wieselthaler N (2004) Modern imaging of tuberculosis in children: thoracic, central nervous system and abdominal tuberculosis. Pediatr Radiol 34:861–875PubMedCrossRef

14.

Przybojewski S, Andronikou S, Wilmshurst J (2006) Objective CT criteria to determine the presence of abnormal basal enhancement in children with suspected tuberculous meningitis. Pediatr Radiol 36:687–696PubMedCrossRef

15.

Cotton MF, Donald PR, Schoeman JF, Aalbers C, Van Zyl LE, Lombard CJ (1991) Plasma arginine vasopressin and the syndrome of inappropriate antidiuretic hormone secretion in tuberculous meningitis. Pediatr Infect Dis J 10:837PubMedCrossRef

16.

Cotton MF, Donald PR, Schoeman JF, Van Zyl LE, Aalbers C, Lombard CJ (1993) Raised intracranial pressure, the syndrome of inappropriate antidiuretic hormone secretion, and arginine vasopressin in tuberculous meningitis. Childs Nerv Syst 9:10–15, discussion 15–16PubMedCrossRef

17.

Roca B, Tornador N, Tornador E (2008) Presentation and outcome of tuberculous meningitis in adults in the province of Castellon, Spain: a retrospective study. Epidemiol Infect 21:1–8

18.

Singh BS, Patwari AK, Deb M (1994) Serum sodium and osmolal changes in tuberculous meningitis. Indian Pediatr 31:1345–1350PubMed

Title: MR imaging of the posterior hypophysis in children with tuberculous meningitis
Authors: Savvas Andronikou
Ronald van Toorn
Els Boerhout
Publication date: 01-09-2009
Publisher: Springer-Verlag
Published in: European Radiology / Issue 9/2009
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-009-1408-4

ACC 2024 Congress

Springer Medicine

MR imaging of the posterior hypophysis in children with tuberculous meningitis

Abstract

ACC 2024 Congress

Springer Medicine

Abstract

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