title: Fulminant cerebral infarction of anterior and posterior cerebral circulation after ascending type of facial necrotizing fasciitis.
abstract: Necrotizing fasciitis is a soft tissue infection that is characterized by extensive necrosis of the subcutaneous fat, neurovascular structures, and fascia. Cerebral infarction after facial necrotizing fasciitis has been rarely reported. A 61-year-old woman with diabetes was admitted with painful swelling of her right cheek. One day later, she was stuporous and quadriplegic. A computed tomographic scan of her face revealed right facial infection in the periorbital soft tissue, parotid, buccal muscle, and maxillary sinusitis. A computed tomographic scan of the brain revealed cerebral infarction in the right hemisphere, left frontal area, and both cerebellum. Four days later, she died from cerebral edema and septic shock. Involvement of the cerebral vasculature, such as the carotid or vertebral artery by necrotizing fasciitis, can cause cerebral infarction. Facial necrotizing fasciitis should be treated early with surgical treatment and the appropriate antibiotic therapy.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea. Electronic address: dohchi@hallym.or.kr.
authors.forename: Hui-Chul
authors.initials: HC
authors.lastname: Choi
authors.affiliation: Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
authors.forename: Chulho
authors.initials: C
authors.lastname: Kim
authors.affiliation: Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
authors.forename: Jong Hee
authors.initials: JH
authors.lastname: Sohn
authors.affiliation: Department of Radiology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
authors.forename: Heung Cheol
authors.initials: HC
authors.lastname: Kim
mesh_terms: D001929:Brain Edema / Q000209:etiology; D002544:Cerebral Infarction / Q000209:etiology / Q000473:pathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000150:complications / Q000473:pathology*; D004562:Electrocardiography; D005145:Face / Q000473:pathology*; D019115:Fasciitis, Necrotizing / Q000150:complications / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D012772:Shock, Septic / Q000209:etiology; D014057:Tomography, X-Ray Computed