title: [A case of meningitis complicated by brainstem infarction].
abstract: 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.
authors.affiliation: Department of Neurosurgery, National Hospital Organization Disaster Medical Center, 3256 Midori-cho, Tachikawa-shi, Tokyo 190-0014, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Takeuchi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Takasato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Masaoka
authors.forename: Takanori
authors.initials: T
authors.lastname: Hayakawa
authors.forename: Naoki
authors.initials: N
authors.lastname: Otani
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Yoshino
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yatsushige
authors.forename: Takashi
authors.initials: T
authors.lastname: Sugawara
authors.forename: Chikashi
authors.initials: C
authors.lastname: Aoyagi
authors.forename: Go
authors.initials: G
authors.lastname: Suzuki
mesh_terms: 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