Imaging of parasitic diseases of the central nervous system

Abstract

Infections of the central nervous system (CNS), especially parasitic infections, have increased in the last decade secondary to the acquired immunodeficiency syndrome (AIDS) epidemic, immunosuppressive therapy used in treatment of cancer, and in organ transplantation. CNS infection is a life-threatening disease; the prognosis depends on early detection and the correct diagnosis of the infection, because once an intracranial infestation is established, the pathogens may produce a severe inflammatory response and serious brain damage. Although laboratory analysis of CSF and CNS biopsy is the gold standard in the identification of the pathogenic agent, neuroimaging plays a crucial role in the early and specific diagnosis of the disease. It is useful not only in the differentiation of CNS infections, relying on the visualization of typical lesion patterns and based on the anatomical compartment involved, but also in the follow-up of treatment response. Magnetic resonance imaging (MRI) is more sensitive than computed tomography (CT) scanning in the detection of focal or diffuse parenchymal lesions and vasculitic complications. © 2008 Springer-Verlag.