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 hypointensity on T2WI with peripheral enhancement, 4) Involution – calcified lesions
• Clinical: 30% have concomitant manifestations of TB outside CNS

Cases of Basilar Meningitis