Neuroimaging for prognosis of central nervous system infections: a systematic review and meta-analysis
Authors' conclusion
Neuroimaging provides essential prognostic information in patients with CNS infections. Abnormal MRI findings, cerebral ischemia, and hydrocephalus are associated with unfavorable outcome, particularly in bacterial meningitis and CNS tuberculosis.
Study context
- Population
- Patients with all-type central nervous system (CNS) infections; studies published January 1st, 2000 to June 1st, 2023
- Participants
- 6,434 patients · 48 studies
- Comparison
- Neuroimaging features and prognosis
- Outcome
- (1) Unfavorable outcome (severe functional disability or death) and (2) mortality
Methodological detailsrandom-effects model, prespecified subgroup analyses
- Random-effects model
- Prespecified subgroup analyses
Pooled result
As reported in the abstract
Unfavorable outcome and mortality
Odds ratio (95% CI)
Abnormal MRIunfavorable outcome; I²=0%
3.55(1.81–6.96)
Brain ischemiaunfavorable outcome; I²=28.5%
4.65(3.14–6.88)
Hydrocephalusunfavorable outcome; I²=61.5%
4.56(2.49–8.36)
Hydrocephalusmortality; I²=61%
3.99(1.83–8.70)
Brain ischemiamortality; I²=16.4%
3.51(2.22–5.54)
Further pooled results
Type of CNS infection (subgroup)
- Associations consistent in bacterial meningitis and CNS tuberculosis, but not in other CNS infections
Country income and intensive care unit (ICU) admission status (subgroup)
- Similar findings
Original publication
Neuroimaging for prognosis of central nervous system infections: a systematic review and meta-analysis. Ann Intensive Care. Published 16 July 2025. doi:10.
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