Pediatric Basilar Meningitis

  • Etiology: Mycobacterium tuberculosis via hematogenous spread
  • Imaging: basilar meningitis, parenchymal extension via Virchow Robin spaces, multiple small ring enhancing tuberculomas at gray-white junction (often in parietal lobe) via hematogenous spread
  • Note: stages are 1) Cerebritis – non-specific edema + ill-defined enhancement, 2) Solid granulomatous – enhancing nodules + surrounding edema, 3) Central caseation – central T2 hypointensity with peripheral enhancement, 4) Involution – calcified lesions
  • Clinical: 30% have concomitant manifestations of TB outside CNS

Radiology Cases of Basilar Meningitis