Article Figures & Data
Figures
- Fig 1.
Patient 13.
A, Nonenhanced (top) and enhanced (bottom) brain CT scans show left small subthalamic hematoma with perivascular enhancement (left), left caudate lacunar infarct, and diffuse periventricular white matter hypoattenuation (right).
B, CT scans obtained 4 months after treatment show that hemorrhage and perivascular enhancement have disappeared, but lacunar infarcts and white matter abnormality persist.
C, Brain T2-weighted (top) and FLAIR (bottom) MR images show increased signal intensity in periventricular white matter
- Fig 2.
Patient 6. Gadolinium-enhanced T1-weighted brain MR images obtained before (top) and after (bottom) treatment show disappearance of dural enhancement
- Fig 3.
Patient 3.
A–C, Gadolinium-enhanced T1-weighted brain MR images show granuloma in the hypothalamus and pituitary granuloma.
D–F, Gadolinium-enhanced T1-weighted brain MR images obtained 4 months after treatment show resolution of the granuloma.
- Fig 4.
Patient 9.
A–D, T1-weighted lumbar MR images obtained before (A and D) and after (B and C) injection of a gadolinium-based contrast agent show enhancement of the lumbar nerve root
- Fig 5.
Patient 14. FLAIR brain MR images show diffuse peripheral subcortical white matter increased signal intensity with predilection to arcuate fibers.
Tables
Clinical and radiologic manifestations and CSF analysis of neurobrucellosis in 23 patients
Patient No./Age (y)/Sex Signs and Symptoms Imaging Findings White Blood Cell Count (WBC) CSF Analysis Protein (mg/L) Brucella* (SAT, 2ME) 1/26/M Headache, ↓hearing, psychosis MR brain: normal. 4 603 320, 160 2/51/M Confusion, spastic gait, ↓hearing MR: periventricular white matter hyperintense lesion (T2 + FLAIR). 6 692 160, 80 3/30/F Headache, deafness, papilledema, sensory ataxia, areflexia MR brain: enhancing granuloma suprasellar region (T1 + contrast). 373 8000 1280, 640 4/59/M Fever, ↓hearing, ataxia, lower limb weakness, areflexia, Babinski CT brain: normal. MR brain: periventricular white matter hyperintense lesions (T2 + FLAIR). 70 1900 320, 320 5/25/M Deafness MR brain: normal. 1 521 40, 40 6/36/M ↓Hearing, ataxia, nystagmus CT brain: normal. MR brain: basal meningeal enhancement (T1 + contrast). 219 8300 640, 640 7/32/M ↓Hearing, spasticity, bilateral Babinski MR brain: right frontal subcortical high signal intensity (T2). 6 1093 640, 640 8/29/F Deafness MR brain: normal. 82 1900 640, 320 9/32/M ↓Hearing, lower limb weakness, areflexia MR lumbar spine: enhancement of nerve root (T1 + contrast). 270 6637 1280, 640 10/58/M Fever, ↓hearing, ataxia CT brain: normal. 490 7930 1280, 1280 11/17/M Fever, lower limb weakness, areflexia MR lumbar spine: enhancement of nerve root (T1 + contrast). 65 2308 160, 160 12/28/F ↓Hearing CT brain: normal. 20 747 80, 80 13/50/M Confusion, seizures, behaviour change, ↓hearing CT brain: bihemisphere white matter hypoattenuation, left caudate lacunae, subthalamic hematoma. MR: diffuse white matter hyperintense lesions (T2 + FLAIR), caudate lacunae, increased signal intensity in pons and left cerebral peduncle (T2). 900 7536 180, 80 14/70/M ↓Hearing, spastic paraparesis, ataxic gait MR brain: diffuse white matter hyperintense lesions (T2 + FLAIR) and basal meningeal enhancement (T1 + contrast). MR spine: normal. 17 2641 160, 160 15/30/F Headache, sixth nerve palsy, papilledema, ↓hearing MR and CT: normal. 500 2370 640, 640 16/30/M Headache, sixth nerve palsy, papilledema, ↓hearing, neck stiffness MR: normal. 42 880 40, 20 17/29/M ↓Hearing, spastic paraparesis MR brain: normal. MR spine: atrophy. 1 460 320, 160 18/32/F ↓Hearing MR: normal. 6 1599 320, 320 19/25/F ↓Hearing, headache MR: normal. 15 2153 80, 80 20/63/M Recurrent transient ischemic attacks, confusion, ↓hearing CT: periventricular hypoattenuations, enhancement of tentorium. MR: periventricular white matter hyperintense lesions (T2 + FLAIR), right cerebellum and pons increased signal intensity (T2). 150 1000 80, 80 21/65/F Headache, confusion, neck stiffness MR: diffuse white matter hyperintense lesions (T2 + FLAIR), left caudate lacunae. 272 2000 640, 640 22/20/F Lower limb weakness, areflexia MR spine: lumbar nerve root enhancement (T1 + contrast). 32 1797 1280, 640 23/47/F ↓Hearing, lower limb weakness, areflexia MR spine: normal. Not performed Note.—↓ indicates decreased; T2, T2-weighted images; T1 + contrast, gadolinium-enhanced T1-weighted images.
* By standard agglutination test before and after precipitation by 2-mercapto-ethanol.
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