Cryptococcosis is a pathology caused by a fungus called Cryptococcus neoformans. It represents the most common fungal infection of the central nervous system in individuals with acquired immunodeficiency syndrome, affecting 11% of individuals in this group. In immunocompromised patients, the usual neurological impairment is subacute meningitis associated with multifocal dilatation of Virchow-Robin perivascular spaces. Immunocompetent patients are more frequently affected in the parenchyma with formation of fungal abscesses called cryptococcomas. Magnetic resonance imaging is more sensitive in cases of cryptococcal meningitis, but in immunocompromised cases, a normal examination is possible due to a lack of inflammation. Meningeal enhancement is demonstrated on FLAIR and T1-weighted images with contrast. There are four described imaging patterns: cryptococcomas, enlarged perivascular spaces, leptomeningeal and parenchymal nodules, and a mixed pattern. Many other conditions may simulate these radiological findings, making it necessary to be aware of them.
Published on: June 24, 2020
Citation: Vasconcelos CRB, Lucato LT, Godoy LFS, Frasseto F, Goldman C, et al. 2020. Neurocryptococcosis: A Pictorial Review. J Med Imaging Case Rep 4(2): 43-45.