Granulomatous Diseases of the CNS: Aetiology, Neuroradiological Features and Clinical Findings.

Abstract

Granulomatous disorders of the central nervous system (CNS) encompass a highly heterogeneous group of diseases with autoinflammatory, autoimmune, infectious, proliferative-neoplastic, foreign body-related, or drug-induced aetiologies. Neuroimaging plays a pivotal role, particularly with respect to early diagnosis. Therefore, knowledge of specific imaging patterns is crucial in order to narrow down the broad differential diagnosis. Although imaging cannot replace histology, its importance in initiating therapy as early as possible is indisputable. This is particularly true since many granulomatous diseases respond to treatment, usually with immunosuppressants and/or anti-infectives. This review highlights representative disease entities across the major aetiological categories and discusses key neuroradiological features and clinical symptoms together with relevant differential diagnostic considerations.