1/23. arachnoiditis and VECP change.A five-year-old boy presented with tuberculous meningitis and subsequently developed amaurosis with optochiasmatic arachnoiditis (OCA) late in the convalescent stage of the illness. The visual evoked cortical potentials were correlated with the decreased and improved postoperative acuity. The diagnosis and classification of OCA have been discussed with emphasis given to prompt neurosurgical treatment.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
2/23. Pachymeningitis with pseudo-Foster Kennedy syndrome.PURPOSE: To report a case of pachymeningitis with pseudo-Foster Kennedy syndrome in a patient who was positive for perinuclear antineutrophil cytoplasmic antibody. methods: Case report. A 44-year-old man was examined for headache and diplopia. RESULTS: Left eye showed limitation of abduction. Ocular fundus, computed tomography (CT), and magnetic resonance imaging (MRI) of the head and orbits were normal. The diplopia subsided spontaneously. Six months later, he noticed sudden visual loss in the left eye. The left eye showed optic disk atrophy and episcleritis, and the right eye showed papilloedema. Computed tomography and MRI exhibited thickened dura mater. serum perinuclear antineutrophil cytoplasmic antibody level was highly increased. CONCLUSION: Pachymeningitis with ocular involvement sometimes requires repeated CT or MRI for diagnosis. This disorder may be caused by microvasculitis.- - - - - - - - - - ranking = 540.37491926857keywords = pachymeningitis, meningitis (Clic here for more details about this article) |
3/23. Optic neuropathy in children with lyme disease.Involvement of the optic nerve, either because of inflammation or increased intracranial pressure, is a rare manifestation of lyme disease. Of the 4 children reported here with optic nerve abnormalities, 2 had decreased vision months after disease onset attributable to optic neuritis, and 1 had headache and diplopia early in the infection because of increased intracranial pressure associated with Lyme meningitis. In these 3 children, optic nerve involvement responded well to intravenous ceftriaxone therapy. The fourth child had headache and visual loss attributable to increased intracranial pressure and perhaps also to optic neuritis. Despite treatment with ceftriaxone and steroids, he had persistent increased intracranial pressure leading to permanent bilateral blindness. Clinicians should be aware that neuro-ophthalmologic involvement of lyme disease may have significant consequences. If increased intracranial pressure persists despite antibiotic therapy, measures must be taken quickly to reduce the pressure.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
4/23. Cranial nerve lesions and abnormal visually evoked potentials associated with the M694V mutation in familial mediterranean fever.A 52-year-old Turkish man with familial mediterranean fever (FMF) due to the homozygous M694V mutation in the MEFV-gene on chromosome 16p13.3, newly developed hemicrania, blurred and double vision, ptosis, ophthalmoparesis and peripheral facial nerve palsy. Except for double vision, all the other abnormalities disappeared spontaneously within 10 days after onset. Markedly prolonged latencies of the visually evoked potentials were also found. At follow-up, 8 months after onset of the neurological abnormalities, right-sided bradydiadochokinesia, right-sided discrete weakness and right-sided hypaesthesia were found. After the exclusion of other hereditary fever syndromes, migraine, stroke, Molaret's meningitis, Behcet's syndrome and mitochondriopathy by clinical, serological, CSF investigations, funduscopy, electroencephalography, and cerebral MRI and MRI angiography, the described neurological abnormalities were regarded as CNS and PNS manifestation of vasculitis or amyloidosis in FMF.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
5/23. Hypertrophic pachymeningitis: case report.Hypertrophic pachymeningits is an unusual cause of neurological symptoms and is often secondary to infections, carcinomatosis or inflammatory diseases. It may also be idiopathic. We report a case of pachymeningitis which was manifested primarily by psychosis and visual loss with optic atrophy and destruction of nasal septum. The patient, a 45 year old woman was submitted to extensive investigation without evidence of any underlying disease. A meningeal biopsy was performed and showed a mostly unspecific inflammatory process with extensive fibrosis of the dura and few early stage granulomas. These findings suggest either neurosarcoidosis or idiopathic hypertrophic pachymeningitis.- - - - - - - - - - ranking = 3212.2495156114keywords = pachymeningitis, meningitis (Clic here for more details about this article) |
6/23. Optic pathways tuberculoma mimicking glioma: case report.BACKGROUND: Optochiasmatic tuberculomas are very rare lesions. They can occur with concomitant tuberculous meningitis, and pulmonary tuberculosis or as the only manifestation of the disease. The authors present a case of optic pathways tuberculoma with radiologic appearance simulating an optic pathways glioma. CASE DESCRIPTION: We report a case of a 20-year-old man with mental retardation due to anoxic encephalopathy who developed a sudden bilateral amaurosis. He also presented with diabetes insipidus, panhypopituitarism, right proptosis, and chemosis. Computed tomography (CT) and magnetic resonance imaging (MRI) showed an enhancing lesion in the optochiasmatic region extending to both optic nerves, with a mass in the right orbit, mimicking an optic pathways glioma. There was no other evidence of systemic involvement of the tuberculosis. The lesion was explored through a right pterional transylvian approach with opening of the optic canal and orbital roof, and a biopsy and an internal decompression were performed. Histopathological studies demonstrated a granulomatous lesion with central caseous necrosis with acid-fast bacilli. The patient improved after treatment with tuberculostatic drugs, but vision recovery could not be achieved. CONCLUSIONS: Visual compromise in tuberculosis is associated with hydrocephalus, optical neuritis or tuberculomas involving the optic pathways. Reviewing the literature on tuberculomas of the optochiasmatic area, we could not find any other case with such extensive involvement of the optic pathways that was radiologically suggestive of an infiltrating glioma. Histopathological studies remain crucial in the diagnosis of intrinsic expansive processes of the optochiasmatic region.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
7/23. Bilateral optic neuropathy and unilateral tonic pupil associated with acute human herpesvirus 6 infection: a case report.BACKGROUND: Human herpesvirus 6 (HHV-6), a widespread virus and causative agent of exanthema subitum in children, has been associated with a number of neurologic disorders including cranial nerve palsies, seizures, encephalitis, meningitis, and multiple sclerosis. PATIENT: A 31-year-old man presented with bilateral optic neuropathy, disc edema, and unilateral tonic pupil, which were found to be associated with acute HHV-6 infection. The patient had been suffering from juvenile diabetes for 5 years. One week after onset of intravenous antiviral therapy with foscarnet, disc edema subsided, and tonic pupil reaction was no longer detectable. CONCLUSIONS: HHV-6 infection may play a role as a causative agent in patients with optic neuropathy and tonic pupil.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
8/23. Cryptococcal optic neuropathy in the acquired immune deficiency syndrome.cryptococcus neoformans infection occurs frequently in patients with the acquired immune deficiency syndrome (AIDS). Cryptococcal meningitis can result in optic neuropathy. Improvement in afferent visual system dysfunction has not been documented. We report three patients with AIDS who developed either unilateral (1) or bilateral (2) afferent visual system dysfunction. The bilaterally affected patients had visual field deficits compatible with chiasmal involvement. All patients had improvement in their vision following appropriate treatment with amphotericin b. Reactivation of cryptococcal infection was heralded by neuro-ophthalmic manifestations in two patients, in spite of maintenance therapy. Despite the poor overall prognosis, AIDS patients with presumed cryptococcal optic neuropathy can benefit from optimal therapy.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
9/23. Neuro-ophthalmologic manifestations of lyme disease.lyme disease is a tick-borne spirochetal infection characterized by skin rash, neurologic, cardiac, and arthritic findings. The authors report six patients with lyme disease who had neuro-ophthalmologic manifestations. One patient had meningitis with papilledema, two had optic neuritis, and one had neuroretinitis. Three patients had sixth nerve paresis, two of whom cleared quickly, whereas multiple cranial nerve palsies and subsequent optic neuropathy developed in another. Early recognition of neuro-ophthalmologic findings can help in the diagnosis and treatment of lyme disease.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
10/23. Optic neuropathy associated with chronic lymphomatous meningitis.A patient with paranasal sinus lymphoma (recognized retrospectively) developed unilateral, acute, self-limited optic neuritis during the course of chronic lymphocytic meningitis with elevated intracranial pressure and headache. Meningeal symptoms were adequately controlled with analgesics alone for 14 months and corticosteroids alone for a subsequent 11 months without evidence of development of other involvement of organs outside the central nervous system (CNS). Eventually, the visual alteration from optic neuritis prompted a repeat evaluation, which disclosed lymphoma in bone marrow. The subject of paraneoplastic optic neuritis is reviewed.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
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