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Methods (San Diego, Calif.) Aug 2017A wide range of viral and microbial infections are known to cause meningitis, and there is evidence that the meninges are the gateway to pathogenic invasion of the brain... (Review)
Review
A wide range of viral and microbial infections are known to cause meningitis, and there is evidence that the meninges are the gateway to pathogenic invasion of the brain parenchyma. Hence observation of these regions has wide application to understanding host-pathogen interactions. Interactions between pathogens and cells of the immune response can be modified by changes in their environment, such as suppression of the flow of blood and lymph, and, particularly in the case of the meninges, with their unsupported membranes, invasive dissection can alter the tissue architecture. For these reasons, intravital imaging through the unperforated skull is the method of choice. We give a protocol for a simple method of two-photon microscopy through the thinned cortical skull of the anesthetized mouse to enable real-time imaging with sub-micron resolution through the meninges and into the superficial brain parenchyma. In reporter mice in which selected cell types express fluorescent proteins, imaging after infection with fluorescent pathogens (lymphocytic choriomeningitis virus, Trypanosoma brucei or Plasmodium berghei) has shown strong recruitment to the cortical meninges of immune cells, including neutrophils, T cells, and putative dendritic cells and macrophages. Without special labeling, the boundaries between the dura mater, the leptomeninx, and the parenchyma are not directly visualized in intravital two-photon microscopy, but other landmarks and characteristics, which we illustrate, allow the researcher to identify the compartment being imaged. While most infectious meningitides are localized mainly in the dura mater, others involve recruitment of immune cells to the leptomeninx.
Topics: Animals; Dendritic Cells; Host-Pathogen Interactions; Intravital Microscopy; Lymphocytic choriomeningitis virus; Macrophages; Meninges; Meningitis; Mice; Mice, Transgenic; Microorganisms, Genetically-Modified; Microscopy, Fluorescence, Multiphoton; Neutrophils; Plasmodium berghei; T-Lymphocytes; Trypanosoma brucei brucei
PubMed: 28351758
DOI: 10.1016/j.ymeth.2017.03.020 -
Enfermedades Infecciosas Y... Dec 2002
Topics: Adult; Anti-Inflammatory Agents; Antibiotics, Antitubercular; Autoimmune Diseases; Female; Fever; Humans; Meningism; Meningitis, Aseptic; Meningitis, Bacterial; Prednisolone; Sjogren's Syndrome
PubMed: 12433357
DOI: 10.1016/s0213-005x(02)72859-0 -
Scandinavian Journal of Infectious... 1990Elevated levels of soluble interleukin-2 receptors (S-IL-2R) but not interleukin-2 (IL-2) activity were found in sera from patients with aseptic meningitis, purulent...
Elevated levels of soluble interleukin-2 receptors (S-IL-2R) but not interleukin-2 (IL-2) activity were found in sera from patients with aseptic meningitis, purulent meningitis, and meningism. Elevated levels of S-IL-2R in serum was also observed in 4/4 patients with bacterial pneumonia and 2/2 patients with infectious mononucleosis. The inflammation of the meninges was only reflected by an increase in S-IL-2R in cerebrospinal fluid (CSF) in 1/14 patients with aseptic meningitis and 3/10 patients with purulent meningitis. Further, IL-2 activity was only demonstrated in CSF from 2 patients with aseptic meningitis and 3 patients with purulent meningitis. In conclusion, neither S-IL-2R nor IL-2 in serum or CSF seem to have any value in the diagnosis of or discrimination between purulent meningitis and aseptic meningitis. Further, the elevation of S-IL-2R in serum is not specific for infections primarily fought by cytotoxic T-lymphocytes such as viral infections, but seems merely to reflect an unspecific activation of the immune system.
Topics: Biological Assay; Cell Line; Enzyme-Linked Immunosorbent Assay; Humans; Immunity, Cellular; Interleukin-2; Meningism; Meningitis; Meningitis, Aseptic; Prognosis; Receptors, Interleukin-2
PubMed: 2371547
DOI: 10.3109/00365549009027055 -
Archives of Pediatrics May 1950
Topics: Meninges; Meningitis; Tuberculosis, Meningeal
PubMed: 15419979
DOI: No ID Found -
Archives of Pediatrics Mar 1950
Topics: Meninges; Tuberculosis, Meningeal
PubMed: 15419966
DOI: No ID Found -
The American Journal of the Medical... Jul 2012Neurocysticercosis (NCC) is endemic in the developing world but is becoming more common in the United States because of immigration. Although NCC is pleomorphic in its... (Review)
Review
Neurocysticercosis (NCC) is endemic in the developing world but is becoming more common in the United States because of immigration. Although NCC is pleomorphic in its presentation, extraparenchymal NCC may be challenging to diagnose and treat. Extraparenchymal NCC is probably more frequent than previously thought. Neurologists and neuroradiologists in the United States are often unaware of the pretreatment/post-treatment radiographic patterns of extraparenchymal NCC and the potentially poor prognosis if not correctly diagnosed and managed. The review of this condition is important given increasing incidence in the United States.
Topics: Humans; Hydrocephalus; Meninges; Meningitis; Neurocysticercosis; Subarachnoid Space; United States
PubMed: 22222333
DOI: 10.1097/MAJ.0b013e31823e6565 -
Scandinavian Journal of Infectious... 1979Adenylate kinase activity and lactate concentration were measured in the cerebrospinal fluid (CSF) of 5 patients with bacterial meningitis, of 4 patients with probable...
Adenylate kinase activity and lactate concentration were measured in the cerebrospinal fluid (CSF) of 5 patients with bacterial meningitis, of 4 patients with probable bacterial meningitis, and of 18 patients with serous meningitis. Furthermore, for comparison measurements were also performed in CSF of 27 patients with meningism. Concomitantly glutathione was measured in CSF in most of the patients. Significantly higher values of these 3 parameters were found in the CSF of patients with bacterial and probable bacterial meningitis compared with those having serous meningitis and meningism. Adenylate kinase activity and lactate concentration in patients with serous meningitis were significantly higher than in those with meningism. All patients with a clinical diagnosis of meningitis studied so far also displayed an adenylate kinase activity in their CSF. The determination of adenylate kinase, lactate and glutathione levels in CSF might be a useful aid for the diagnosis not only of meningitis but also for the discrimination between bacterial and serous meningitis.
Topics: Adenylate Kinase; Adolescent; Adult; Aged; Bacterial Infections; Child; Child, Preschool; Female; Glutathione; Humans; Infant; Lactates; Male; Meningism; Meningitis; Meningitis, Viral; Middle Aged; Phosphotransferases
PubMed: 217082
DOI: 10.3109/inf.1979.11.issue-1.02 -
JAMA Neurology Jan 2017Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system traditionally characterized by an initial relapsing-remitting clinical course... (Review)
Review
IMPORTANCE
Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system traditionally characterized by an initial relapsing-remitting clinical course and focal inflammatory lesions that have a predilection for the periventricular white matter. Recently, however, histopathologic and imaging studies have illustrated a more complex pathologic substrate involving cortical demyelination, gray matter atrophy, and meningeal inflammation. Neuroimaging advances have facilitated improved detection of cortical pathology, but our understanding of the pathogenesis of cortical disease remains incomplete. The purpose of this review is to evaluate the current status and future prospects regarding the emerging role of magnetic resonance imaging to visualize leptomeningeal enhancement in patients with MS and place these findings in the proper pathobiologic and clinical context.
OBSERVATIONS
Cortical atrophy and demyelination along the subpial surface appear early in the disease course in patients with MS but accelerate in progressive stages. Histopathologic studies of patients have shown the presence of inflammatory infiltrates, in some cases with features of B cell-rich tertiary lymph follicles, along the cortical meningeal surface. Recent magnetic resonance imaging data demonstrate the ability to detect such inflammation using high-resolution gadolinium-enhanced contrast scans by the presence of leptomeningeal enhancement. Clinical and magnetic resonance imaging correlation studies indicate that leptomeningeal enhancement is most common in patients with progressive forms of MS and shows a relationship to subpial cortical lesions and cortical atrophy.
CONCLUSIONS AND RELEVANCE
A growing body of evidence suggests that gray matter demyelination, cortical atrophy, and leptomeningeal inflammation may be important components of progressive MS pathology and provide a new therapeutic target. Leptomeningeal enhancement may prove a useful surrogate marker for such pathology, perhaps improving our understanding of the natural history of progressive MS, although its ultimate effect on therapeutic development and clinical care requires further study.
Topics: Humans; Magnetic Resonance Imaging; Meninges; Meningitis; Multiple Sclerosis
PubMed: 27893883
DOI: 10.1001/jamaneurol.2016.4237 -
Seminars in Ultrasound, CT, and MR Dec 1994In the past two decades, the advent of CT and MRI has made a considerable impact on the evaluation of meningeal diseases, conditions once regulated to cytological,... (Review)
Review
In the past two decades, the advent of CT and MRI has made a considerable impact on the evaluation of meningeal diseases, conditions once regulated to cytological, histopathological, or postmortem analyses alone. This article reviews the imaging findings in various meningeal processes with particular attention to the anatomic definition of the meningeal layers and their relationship to the development of meningeal pathology and consequent imaging characteristics.
Topics: Central Nervous System Diseases; Humans; Magnetic Resonance Imaging; Meningeal Neoplasms; Meninges; Meningitis; Tomography, X-Ray Computed
PubMed: 7880563
DOI: 10.1016/s0887-2171(05)80018-6 -
Radiology Nov 1996The structural organization of the dura and leptomeninges is reflected in its magnetic resonance (MR) imaging appearance in normal and disease states. Two distinct... (Review)
Review
The structural organization of the dura and leptomeninges is reflected in its magnetic resonance (MR) imaging appearance in normal and disease states. Two distinct enhancement patterns are characterized: dura-arachnoid enhancement and pia-subarachnoid space enhancement. The dura-arachnoid pattern consists of curvilinear enhancement overlying the brain and immediately deep to the inner table of the calvaria, as well as along the falx and tentorium. Pial enhancement closely follows the brain surface into sulci and outlines the basal cisterns. Recognition of these enhancement patterns and other MR imaging characteristics may enhance the role of MR imaging in the detection, diagnosis, and follow-up of neoplastic and nonneoplastic disorders affecting the meninges. The focus of this article (Part I) is the MR appearance of the normal meninges and nonneoplastic causes of meningeal disease. Part II of this series will discuss neoplastic conditions affecting the coverings of the brain and spinal cord with an emphasis on pathways of disease spread.
Topics: Cerebrovascular Disorders; Humans; Magnetic Resonance Imaging; Meninges; Meningitis
PubMed: 8888215
DOI: 10.1148/radiology.201.2.8888215