Case Notes
History
21 yo male presenting with acute headache, meningismus, and pleocytosis on CSF analysisExam
MR T2-w turbo spin-echo
Prior Study
MR flair1. There is evidence of hyperacute, primary, leptomeningitis. There is no evidence of abscess formation.
MR T1-w post contrast
1. There is abnormal leak of contrast into sulci over much of the brain plus evidence of venous hyperemia. These findings are consistent with the hyperacute phase of leptomeningitis.
2. There is evidence of early raised intracranial pressure.
MR diffusion
1. The DWI map findings are consistent with acute leptomeningeal infection. There is no restriction within the brain nor extraaxial spaces.
MR SWI
1. SWI evidence of post inflammatory venous hyperemia.
2. There is no acute microhemorrhage.