The prognostic factors of HIV-negative adult cryptococcal meningitis with a focus on cranial MRI-based neuroimaging findings

Publication date: Available online 2 July 2018Source: Journal of Clinical NeuroscienceAuthor(s): Wan-Chen Tsai, Chia-Yi Lien, Jun-Jun Lee, Wei-Che Lin, Che-Wei Hsu, Chi-Ren Huang, Nai-Wen Tsai, Chiung-Chih Chang, Cheng-Hsien Lu, Wen-Neng ChangAbstractThe prognostic significance of clinical characteristics and neuroimaging features, especially cranial magnetic resonance imaging (MRI)-based neuroimaging features, in patients with human immunodeficiency virus (HIV)-negative cryptococcal meningitis (CM) has rarely been examined in the literature. We analyzed the clinical characteristics and MRI findings of 65 HIV-negative patients (43 men, 22 women, age 19–86 years) collected during a study period of 15 years (January 2001–December 2015). Their underlying conditions included diabetes mellitus, liver cirrhosis, hematologic disorders, autoimmune disorders, malignancy, chronic obstructive pulmonary disease, adrenal insufficiency and organ transplantation, and their clinical presentations included headache, altered consciousness, fever, seizure, visual disturbance and hearing impairment. The main cranial MRI findings were basal meningeal enhancement (44.6%, 29/65), dilated Virchow-Robin space/pseudocyst (43.1%, 28/65), “dirty” cerebrospinal fluid sign (38.5%, 25/65), hydrocephalus (36.9%, 21/65), acute/subacute cerebral infarct (ASCI, 21.5%, 14/65), cryptococcoma (9.2%, 6/65), and hazy brain base (1.5%, 1/65). The therapeutic results of the 65 patients were evaluated usin...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research