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Neurocritical Care
Published in: Neurocritical Care 3/2009

01-12-2009 | Neuroimage

Imaging Findings in Pyogenic Ventriculitis

Authors: Philippe G. Jorens, Maurits H. Voormolen, Dominique Robert, Paul M. Parizel

Published in: Neurocritical Care | Issue 3/2009

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Abstract

Introduction

Pyogenic ventriculitis is an uncommon but often severe intracranial infection.

Methods

Case report with illustrative CT and MRI imaging.

Results

A 49-year-old man presented with an intraparenchymal hematoma with extension of blood into the ventricles. The persistence of intraventricular blood necessitated long term placement of an external ventricular drain. On day 23 after admission, a contrast-enhanced CT scan of the brain showed slight hydrocephalus, irregular debris in the dependent part of the occipital horns and periventricular hypodensities. An MRI scan confirmed the characteristic hallmarks of pyogenic ventriculitis on the T2-weighted, Fluid Attenuated Inversion Recovery (FLAIR), and diffusion-weighted and contrast-enhanced T1-weighted images.

Conclusion

Neuroimaging is crucial in clearly depicting pyogenic ventriculitis. A contrast-enhanced CT scan, but especially MR imaging, is an ideal tool to reliably diagnose this life-threatening cerebral infection.
Literature
1.
Korinek AM, Reina M, Boch AL, Rivera AO, De Bels D, Puybasset L. Prevention of external ventricular drain-related ventriculitis. Acta Neurochir (Wien). 2005;147(1):39–45.CrossRef
2.
Kastrup O, Wanke I, Maschke M. Neuroimaging of infections. Neuroradiology. 2005;2:324–32.
3.
Fukui MB, Williams RL, Mudigonda S. CT and MRI imaging features of pyogenic ventriculitis. Am J Neuroradiol. 2001;22:1510–6.PubMed
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Fujikawa A, Tsuchija K, Honya K, Nitatori T. Comparison of MRI sequences to detect ventriculitis. AJR Am J Roentgenol. 2006;187:1048–53.CrossRefPubMed
5.
Pezzulo JA, Tung GA, Mudigonda S, Rogg JM. Diffusion-weighted imaging of pyogenic ventriculitis. AJR Am J Roentgenol. 2003;180:71–5.
Metadata
Title
Imaging Findings in Pyogenic Ventriculitis
Authors
Philippe G. Jorens
Maurits H. Voormolen
Dominique Robert
Paul M. Parizel
Publication date
01-12-2009
Publisher
Humana Press Inc
Published in
Neurocritical Care / Issue 3/2009
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-009-9263-3

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