[A case of meningitis complicated by brainstem infarction].
A rare case of meningitis complicated by brainstem infarction is reported. A 64-year-old previously healthy female was admitted to our hospital because of a 1-week history of fever and headache. Cefdinir was orally administered for several days before admission. Analysis of cerebrospinal fluid (CSF) on admission showed a white blood cell (WBC) count of 9,013 cells/ micro/(97% polynuclear cells), a protein level of 212.8 mg/d/, and a glucose level of 3 mg/d/. CSF culture was negative for bacteria, including tubercle bacilli, and fungi. A brain computed tomography (CT) scan on admission showed acute hydrocephalus. Six hours after admission the patient developed tetraplegia. Diffusion-weighted magnetic resonance (MR) images on day 2 revealed elevated diffusion coefficients with high signal intensity in the pons and the medulla oblongata. MR angiography demonstrated a narrowing change of the cerebral arteries. Followup MR angiography two months after admission showed normalization of the cerebral arteries. The patient remained tetraplegic at eight months after admission. We speculated that brainstem infarction in our case might have been caused by vascultis or brain edema.
Takeuchi
Satoru
S
Department of Neurosurgery, National Hospital Organization Disaster Medical Center, 3256 Midori-cho, Tachikawa-shi, Tokyo 190-0014, Japan.
Takasato
Yoshio
Y
Masaoka
Hiroyuki
H
Hayakawa
Takanori
T
Otani
Naoki
N
Yoshino
Yoshikazu
Y
Yatsushige
Hiroshi
H
Sugawara
Takashi
T
Aoyagi
Chikashi
C
Suzuki
Go
G
D001933:Brain Stem / Q000098:blood supply*; D002544:Cerebral Infarction / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008581:Meningitis / Q000150:complications*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed