title: Delayed recurrent ischemic stroke after initial good recovery from pneumococcal meningitis.
abstract: We describe unusual delayed recurrent episodes of ischemic stroke in a patient with initial good recovery from pneumococcal meningitis due to progressive arterial stenosis for over 3 months. We postulate that any of the following may have been responsible for his condition: widespread cerebral vasculopathy due to the effects of purulent material bathing the base of the brain, an immune-mediated para-infectious condition, or a rebound effect of the primary inflammatory reaction that was initially suppressed by dexamethasone. This case demonstrates that progressive arterial stenosis can evolve months after bacterial meningitis and should be recognized as a potential vascular complication.
authors.affiliation: Department of Neurology and Cerebrovascular Medicine, Saitama International Medical Center, Saitama Medical University, Japan. yujik@saitama-med.ac.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kato
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Takeda
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Dembo
authors.forename: Norio
authors.initials: N
authors.lastname: Tanahashi
mesh_terms: D000081:Acetamides / Q000627:therapeutic use; D001925:Brain Damage, Chronic / Q000209:etiology; D002545:Brain Ischemia / Q000188:drug therapy / Q000209:etiology*; D002443:Ceftriaxone / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000150:complications / Q000188:drug therapy; D003251:Constriction, Pathologic; D003907:Dexamethasone / Q000627:therapeutic use; D018450:Disease Progression; D004359:Drug Therapy, Combination; D006801:Humans; D000069349:Linezolid; D008297:Male; D008586:Meningitis, Pneumococcal / Q000150:complications* / Q000188:drug therapy; D000077731:Meropenem; D008875:Middle Aged; D023303:Oxazolidinones / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D012008:Recurrence; D013845:Thienamycins / Q000627:therapeutic use
chemical_list: D000081:Acetamides; D023303:Oxazolidinones; D010975:Platelet Aggregation Inhibitors; D013845:Thienamycins; D002443:Ceftriaxone; D003907:Dexamethasone; D011239:Prednisolone; D000077731:Meropenem; D000069349:Linezolid