11/1027. Complications of lumbar puncture with injection of hydrosoluble material.We report two cases of severe disorders after spinal puncture with injection of hydrosoluble material. The first case concerned a 36-year-old woman with intrathecal injection of 125 ml of hydrocortisone acetate. An intracranial occipital hematoma developed. The second case concerned a 26-year-old man with intrathecal injection of contrast media and hydrocortisone. A chemical meningitis occurred. In both cases the natural course was favorable. Both complications are well known but rare. A review of the literature is made with description of the mechanisms. Preventive therapeutic measures are reported.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
12/1027. mycobacterium fortuitum meningitis associated with an epidural catheter: case report and a review of the literature.mycobacterium fortuitum is a rapidly growing organism that has rarely been associated with meningitis. A patient developed M. fortuitum meningitis as the result of a permanent indwelling, contaminated, epidural catheter. diagnosis and treatment of the disease are difficult in that clinical features may be indolent, and many antimicrobials with activity against M. fortuitum have minimal cerebrospinal fluid penetration. This patient was cured with an antibiotic regimen that consisted of doxycycline, ciprofloxacin, imipenem, and clarithromycin, and removal of the epidural catheter.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
13/1027. Acute bacterial meningitis secondary to gamma hemolytic streptococcus. Case report and review of the literature.Gamma hemolytic streptococcal meningitis in a 17-year-old boy resulted in a severe purulent reaction and death. review of the literature shows only one other case of a gamma hemolytic streptococcus as the cause of bacterial meningitis in the absence of endocarditis.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
14/1027. Eosinophilic meningitis. An unusual cause of headache.Human parasitic infections are uncommon outside the tropical north but common in animals throughout australia. The rat lung worm, angiostrongylus cantonensis, can invade the human brain to cause a chronic meningitis with prolonged headache. This condition can be diagnosed by finding a high eosinophil count in cerebrospinal fluid (CFS), the lumbar puncture also provides symptomatic relief. The outcome is usually benign but death has been reported.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
15/1027. Metastatic adenocarcinoma masquerading as basal pontine tuberculoma.Tuberculous infection of the central nervous system is common in hong kong. A 39-year-old woman presented with isolated right sixth nerve palsy which was non-progressive for 10 months. Neuro-imaging revealed a right pontine lesion. cerebrospinal fluid (CSF) examination showed lymphocytic meningitis with negative bacteriological and cytological studies. Empirical antituberculous drugs with initial corticosteroid resulted in improved CSF parameters. A diagnosis of cerebral tuberculoma complicated by meningitis was made. She subsequently deteriorated clinically and radiologically. Despite a number of clinical features which were atypical of leptomeningeal metastasis, adenosquamous carcinoma was found on biopsy. Her relatively indolent clinical course might be due to the initial corticosteroid treatment. This report illustrates the importance of early tissue diagnosis in uncertain cases of chronic lymphocytic meningitis.- - - - - - - - - - ranking = 3keywords = meningitis (Clic here for more details about this article) |
16/1027. Pachymeningitis and optic neuritis in rheumatoid arthritis: MRI findings.Rheumatoid arthritis is a systemic disease in which cerebral and eye involvement is neither common nor fully understood. Although it is rarely the cause of pachymeningitis and optic neuritis, rheumatoid arthritis should always be kept in mind in these two conditions. We present a 52-year-old male with an 8 month history of rheumatoid arthritis who was referred to the neurology department with headache and decreasing vision and was diagnosed as having rheumatoid pachymeningitis and optic neuritis on the basis of MRI findings.- - - - - - - - - - ranking = 9.150949478571keywords = pachymeningitis, meningitis (Clic here for more details about this article) |
17/1027. Idiopathic giant-cell granulomatous hypophysitis mimicking acute meningitis.A 32-year-old woman presented with severe headache, photophobia, fever, nausea, vomiting, and worsening vision. She had also noted several months of amenorrhea. She was febrile to 38.9 degrees C. Laboratory evaluation revealed a markedly elevated erythrocyte sedimentation rate. Lumbar puncture revealed a cerebrospinal fluid lymphocytic pleocytosis and an elevated protein level. Endocrine studies revealed evidence of panhypopituitarism without diabetes insipidus. A magnetic resonance imaging study showed a 2-cm pituitary mass with optic chiasmal compression. The patient had a trans-sphenoidal resection of the mass. pathology revealed multinucleated giant cells in necrotic debris, but no evidence of pituitary tumor. Studies looking for evidence of systemic granulomatous disease were negative. The patient was considered to have idiopathic giant-cell granulomatous hypophysitis. After surgery, the patient's vision improved and hormone replacement therapy was initiated. This case illustrates that idiopathic giant-cell granulomatous hypophysitis should be considered in the differential diagnosis of a patient presenting with a pituitary mass, hypopituitarism, and meningitis-like symptoms.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
18/1027. Hypertrophic cranial pachymeningitis involving dural sinuses: a pseudo signal-void appearance on MRI.A case of hypertrophic cranial pachymeningitis with an unusual and misleading manifestation is reported. CT detected calcified tentorium and superior sagittal sinus. MR imaging and MR angiography depicted tentorial thickening as well as occlusion of all major dural sinuses. Fibrocalcific occlusion of dural sinuses showed interestingly signal-void appearance on spin-echo images which could readily be interpreted as being patent sinuses.- - - - - - - - - - ranking = 12.877373696427keywords = pachymeningitis, meningitis (Clic here for more details about this article) |
19/1027. salmonella meningitis treatment with intravenous trimethoprim.Intravenous trimethoprim and sulphadiazine were used in the successful treatment of salmonella meningitis in a four months old child. Pharmacological data are presented which show good penetration of the bloodbrain barrier by trimethoprim. This combination appears to be a useful alternative therapy for gram-negative meningitis.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
20/1027. Idiopathic hypertrophic cranial pachymeningitis: clinicoradiological spectrum and therapeutic options.OBJECTIVE: Idiopathic hypertrophic cranial pachymeningitis is a rare disease, of undetermined pathogenesis, that is characterized by inflammation and fibrosis of the dura mater. methods: We encountered six patients with idiopathic hypertrophic cranial pachymeningitis and analyzed their clinical presentations, radiological findings, and treatment. RESULTS: In the six patients, the main manifestations were cranial nerve palsies and headache. Three associations were present, namely optic neuropathy, tolosa-hunt syndrome, and diabetes insipidus. gadolinium-enhanced magnetic resonance imaging was diagnostic, showing intense dural enhancement in a linear or nodular pattern. The responses to corticosteroid therapy were better for patients who exhibited linear, rather than nodular, dural enhancement. For one patient, surgical decompression of the superior orbital fissure provided lasting relief. The course of the disease followed one of three patterns, i.e., sustained remission, relapse with corticosteroid independence, or relapse with corticosteroid dependence. pulse corticosteroid therapy provided significant relief, while reducing the daily corticosteroid requirement and avoiding side effects, for a corticosteroid-dependent relapsing patient. CONCLUSION: Idiopathic hypertrophic cranial pachymeningitis exhibits varied clinical courses. It is important to prevent irreversible cranial neuropathy during the active phase of the disease, using daily administration of corticosteroids, pulse corticosteroid therapy, or surgical decompression.- - - - - - - - - - ranking = 18.028323174998keywords = pachymeningitis, meningitis (Clic here for more details about this article) |
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