Intracranial infection

The advent of computed tomography (CT) revolutionized the diagnostic evaluation of the patient in whom intracranial infection was suspected. CT provided information about the presence or absence of a mass, its location, its effect on the ventricular system and subarachnoid pathways, and with the use of intravenous radiographic contrast agents, the state of the blood-brain barrier (BBB). The CT information supplanted that obtained from more invasive imaging studies (ventriculography, pneumoencephalography, and arteriography). In little more than a decade following the introduction of CT, magnetic resonance imaging (MRI) has become a clinical tool. The question is now, Will MRI alter the role of CT in the evaluation of intracranial infections and if so, for what reasons? The experience with MRI in the evaluation of intracranial infections has thus far been restricted because of an insufficient number of scanners and their limited availability for inpatients. Moreover, this new technique is still under development, and any data accumulated are preliminary. Thus, the literature on the application of MRI to intracranial infections has so far been sparse. The aim of this chapter is to put into perspective our initial experience with MRI in intracranial infections