Long-Term Neuropsychological Sequelae in HIV-Seronegative Cryptococcal Meningoencephalitis Patients with and without Ventriculoperitoneal Shunts: A Cine MRI StudyReport as inadecuate




Long-Term Neuropsychological Sequelae in HIV-Seronegative Cryptococcal Meningoencephalitis Patients with and without Ventriculoperitoneal Shunts: A Cine MRI Study - Download this document for free, or read online. Document in PDF available to download.

Behavioural Neurology - Volume 2015 2015, Article ID 356476, 10 pages -

Research Article

Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83305, Taiwan

Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83305, Taiwan

Department of Biological Science, National Sun Yat-Sen University, Kaohsiung 804, Taiwan

Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83305, Taiwan

Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei 11221, Taiwan

Department of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83305, Taiwan

Department of Radiology, Yuan’s General Hospital, Kaohsiung 802, Taiwan

Department of Radiology, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan

Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83305, Taiwan

Received 13 November 2014; Revised 9 March 2015; Accepted 20 March 2015

Academic Editor: João Quevedo

Copyright © 2015 Meng-Hsiang Chen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Hydrocephalus in cryptococcal meningoencephalitis is most commonly managed with a ventriculoperitoneal shunt. This study applied cine magnetic resonance imaging MRI to evaluate initial disease severity on long-term cerebrospinal fluid CSF flow dynamics and associated neuropsychological sequelae in cryptococcal meningoencephalitis patients with and without ventriculoperitoneal shunts. Methods. Eighteen human immunodeficiency virus-seronegative cryptococcal meningoencephalitis patients 10 with shunts versus 8 without shunts were compared with 32 age- and sex-matched healthy volunteers. All subjects underwent complete neurologic examination and neuropsychological testing. Cine MRI was conducted to evaluate CSF flow parameters. Initial CSF laboratory analysis and imaging findings were correlated with present CSF flow parameters and neuropsychological scores. Results. Patients without shunts had higher average flow than controls, suggesting chronic hydrocephalus. Initial Evans ratios and CSF glucose levels were associated with CSF peak velocity and flow. Worsening CSF flow parameters correlated with decreased neuropsychological performance. Conclusions. CSF flow parameter differences between the cryptococcal meningoencephalitis patients both with and without ventriculoperitoneal shunts could be detected by cine MRI and correlated with acute stage disease severity and chronic stage neuropsychological results. Cine MRI is useful for assessing the chronic hydrocephalus that may lead to neuropsychological deficits in cryptococcal meningoencephalitis patients.





Author: Meng-Hsiang Chen, Cheng-Hsien Lu, Hung-Chen Wang, Hsiu-Ling Chen, Nai-Wen Tsai, Shau-Hsuan Li, Nai-Wen Hsu, Wei-Ming Lin, 

Source: https://www.hindawi.com/



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