title: Cerebral arteritis with extremely late onset secondary to bacterial meningitis - case report - .
abstract: A 59-year-old woman presented with bacterial meningitis causing arterial narrowing in the very late stage. She initially underwent transsphenoidal surgery for massive non-functioning pituitary adenoma resulting in gross total removal. The postoperative course was uneventful, and she was discharged 12 days after surgery. Fourteen months later, she presented with bacterial meningitis due to streptococcus. Administration of multiple antibiotics resulted in normalization of cerebrospinal fluid findings. Forty days after meningitis onset, she suddenly suffered motor weakness of the right extremities. Magnetic resonance (MR) angiography revealed multiple intracranial arterial narrowings. Despite intensive treatment, no improvement of arterial narrowing was seen, and she suffered cerebral infarction. Six months after the onset of meningitis, MR angiography still showed multiple arterial narrowings, and MR plaque imaging of the stenotic vessel disclosed thickened arterial wall. This case illustrates the complex time course of arteritis caused by severe bacterial meningitis, and the intractability to treatment.
authors.affiliation: Department of Neurosurgery, Kohnan Hospital, Sendai, Miyagi, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Ogawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Inoue
authors.forename: Teiji
authors.initials: T
authors.lastname: Tominaga
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001167:Arteritis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging; D002539:Cerebral Arterial Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D016920:Meningitis, Bacterial / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D008875:Middle Aged; D011859:Radiography; D013290:Streptococcal Infections / Q000150:complications* / Q000628:therapy; D013997:Time Factors; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents