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題名 | CNS Cryptococcosis: Clinical and MRI Findings= |
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作者 | Chang, Cheng-sue; Wang, Pao-yu; |
期刊 | Acta Neurologica Taiwanica |
出版日期 | 20001200 |
卷期 | 9:4 民89.12 |
頁次 | 頁290-296 |
分類號 | 415.9 |
語文 | eng |
關鍵詞 | 中樞神經系統; 磁振造影; Cryptococcosis; Central nervous system; Magnetic resonance imaging; |
英文摘要 | The purpose of this study was to analyze the clinical features, findings of cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI) in patients with CNS cryptococcal infections. After the installation of MR imaging in February 1989 at our hospital up until December 1997, a total of seven patients who had undergone MRI study were diagnosed with cryptococcal meningitis. The clinical data, findings of MRI and CSF were reviewed and analyzed retrospectively. The study group consisted of three men and four women, and ages ranged from 15 to 38 years. Underlying immunocompromised conditions were present in four patients. All patients had severe progressive headache. Only two patients had low-grade fever. Meningeal sign, conscious disturbance, and 6th cranial nerve palsy were present in some patients. All patients had increased opening pressure, pleocytosis, and high cryptococcal antigen titers in CSF. Six patients had elevated protein levels, positive results for cryptococcosis on India ink stain and fungal culture of CSF. Decreased sugar levels were present in five patients. MRI showed dilated Virchow-Robin space in one patient, leptomeningeal enhancement in three patients, focal lesions in two patients, focal enhancing lesions in another two patients, and hydrocephalus in three patients. However, one patient had normal MRI images. CNS cryptococcosis produces a wide variety of MRI appearances including dilated Virchow-Robin spaces, leptomeningeal enhancement, focal enhancing lesions, focal lesions and hydrocephalus. Cryptococcal meningitis is highly suggested when MRI reveals typical findings such as dilated Virchow-Robin spaces, however, normal or nonspecific findings of MRI do not exclude the diagnosis. |
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