Dilated Virchow-Robin Spaces in Cryptococcal Meningitis Associated with AIDS

Wehn, S M; Heinz, E R; Burger, Peter C.; Boyko, Orest B.

doi:10.1097/00004728-198909000-00002

Cited by 72 publications

(30 citation statements)

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“…The Virchow-Robin spaces appear as the main anatomic sites involved, even radiologically during cerebral cryptococcosis. 20 The cryptococcal organisms spread from the basal cisterns through the Virchow-Robin spaces, dilating these spaces, to ultimately propagate in the lentiform nucleus. Such lesions have been described as characteristic for cryptococcosis, which show these lesions to be small cystic collections of cryptococcal organisms.…”

Section: Discussionmentioning

confidence: 99%

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Assessing the Chronic Neuropsychologic Sequelae of Human Immunodeficiency Virus–Negative Cryptococcal Meningitis by Using Diffusion Tensor Imaging

Lu¹,

Chen²,

Chang³

et al. 2011

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

“…[19][20][21][22] Meningitis also could lead to periventricular WM injury by glial cell infiltration. 15 The spectrum of abnormalities on MR imaging reflected potential anatomies of fungal invasion.…”

Section: Roi Analysis Of Dti Datamentioning

confidence: 99%

Assessing the Chronic Neuropsychologic Sequelae of Human Immunodeficiency Virus–Negative Cryptococcal Meningitis by Using Diffusion Tensor Imaging

Lu¹,

Chen²,

Chang³

et al. 2011

AJNR Am J Neuroradiol

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“…Disease progression is associated with increased V-R size and hyperintensities on T2-weighted images in the basal ganglia, cerebellum, and cerebral white matter [107,108]. The cryptococcal organisms disseminate from the basal cisterns, through the V-R spaces, causing dilation in these spaces, and then spread to the basal ganglia, internal capsule, thalamus, and brain stem [109]. However, enlarged perivascular spaces are not always pathogonomic of cryptococcosis, as dilation can also happen as a consequence of normal aging and, therefore, the appearance of the surrounding tissue on MRI scans must also be taken into account [110].…”

Section: Other Infectious Diseasesmentioning

confidence: 99%

The Role of Medical Imaging in Defining CNS Abnormalities Associated with HIV-Infection and Opportunistic Infections

et al. 2011

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Summary:In this review of the current literature, we examine the role of medical imaging in providing new and relevant information on central nervous system (CNS) injury associated with human immunodeficiency virus (HIV) infection and various clinical manifestations of this injury. Common imaging modalities used to examine CNS injury in HIV infection include structural magnetic resonance imaging, magnetic resonance spectroscopy, diffusion tensor imaging, functional MRI, and positron emissions tomography. Clinical implications for the findings are discussed for each of these modalities individually and collectively. In addition, the direction for future studies is suggested in an attempt to provide possible methods that might answer the many questions that remain to be answered on the evolution and progression of CNS injury in the context of HIV infection.

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“…8 Extension of infection from the meninges along perforating arteries into the Virchow-Robin (VR) spaces results in cystic collections of yeast organisms known as gelatinous pseudocysts, which can sometimes be seen on magnetic resonance imaging (MRI). [9][10][11][12] Large, intraparenchymal cryptococcomas are more commonly reported in immunocompetent patients. These often are contrastenhancing on T1-weighted (T1W) spin-echo images, reflecting the immune response to the organism.…”

mentioning

confidence: 99%

Clinical Signs, Imaging Features, Neuropathology, and Outcome in Cats and Dogs with Central Nervous System Cryptococcosis from California

Sykes

Sturges

Cannon

et al. 2010

Journal of Veterinary Internal Medicine

156

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Background: Cryptococcus spp. is a fungal pathogen with a predilection for the central nervous system (CNS). Objectives: To compare the clinical, advanced imaging, and neuropathologic findings in dogs and cats with CNS cryptococcosis, and to evaluate outcome of treatment in these animals.Animals: Twenty-six cats and 21 dogs with CNS cryptococcosis. Methods: Medical records were reviewed for clinical findings and results of CNS imaging. Archived cerebrospinal fluid and CNS tissue specimens were reviewed for pathology. Findings in cats were compared with those in dogs and the effects of variables on survival were determined by survival curve analysis.Results: When present, pain was localized to the cervical region in dogs and was generalized or localized to the thoracolumbar spine or pelvic limbs in cats. Magnetic resonance imaging (MRI) findings were variable but correlated with CNS histopathological findings of meningitis, meningitis with gelatinous pseudocyst formation, and granulomatous mass lesions. Peripherally enhancing brain lesions were seen only in cats. Histopathologically, the inflammatory response was milder in cats compared with dogs. Remissions of !1 year occurred in 32% of treated animals. Altered mentation was associated with negative outcome. Glucocorticoid use after diagnosis was associated with improved survival in the first 10 days.Conclusions and Clinical Importance: Lesions seen on MRI reflected neuropathological findings and were similar to those reported in human patients. The immune response to infection may differ between cats and dogs, or relate to the infecting cryptococcal species. Long-term (46 month median survival time) survival may be possible in animals surviving !4 days after diagnosis.

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Dilated Virchow-Robin Spaces in Cryptococcal Meningitis Associated with AIDS

Cited by 72 publications

References 0 publications

Assessing the Chronic Neuropsychologic Sequelae of Human Immunodeficiency Virus–Negative Cryptococcal Meningitis by Using Diffusion Tensor Imaging

Assessing the Chronic Neuropsychologic Sequelae of Human Immunodeficiency Virus–Negative Cryptococcal Meningitis by Using Diffusion Tensor Imaging

The Role of Medical Imaging in Defining CNS Abnormalities Associated with HIV-Infection and Opportunistic Infections

Clinical Signs, Imaging Features, Neuropathology, and Outcome in Cats and Dogs with Central Nervous System Cryptococcosis from California

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