11/28. Cat scratch disease associated with neuroretinitis in a 6-year-old girl.Cat scratch disease is a subacute regional lymphadenitis usually preceded by a history of being scratched by a cat or young kitten. The spectrum of illness ranges from mild self-limited adenopathy to severe systemic disease, including hepatosplenomegaly, encephalopathy, osteolytic lesions, splenic abscesses, mediastinal masses, and neuroretinitis. Vision loss is a rare complication of the disease. The authors report a patient with cat scratch disease associated with acute febrile illness, lymphocytic meningitis, and acute vision loss secondary to neuroretinitis. To their knowledge, this is the first ophthalmic case reported in which the diagnosis is supported by both a positive skin test and positive histopathology.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
12/28. Acute monocular visual loss in carcinomatous hypertrophic pachymeningitis mimicking giant cell arteritis.This report describes a 69-year-old woman who presented with acute monocular visual loss, ipsilateral headache, and elevated sedimentation rate and c-reactive protein. Both temporal artery biopsies were negative. neuroimaging, dural biopsy, and breast biopsy all confirmed the diagnosis of carcinomatous hypertrophic pachymeningitis associated with metastatic breast carcinoma. After treatment with corticosteroids, her vision improved. Her clinical presentation initially mimicked the symptoms and signs of giant cell arteritis. Acute monocular visual loss without other cranial nerve palsies may be an uncommon presentation of hypertrophic pachymeningitis from metastatic breast carcinoma.- - - - - - - - - - ranking = 138.52664595596keywords = pachymeningitis, meningitis (Clic here for more details about this article) |
13/28. Optic neuropathy associated with cryptococcal arachnoiditis in AIDS patients.We studied two cases of bilateral visual loss secondary to an optic neuropathy in patients with cryptococcal meningitis. In both cases a history of visual loss after the onset of an episode of cryptococcal meningitis was elicited. visual fields were consistent with optic nerve disease. The patients' visual loss appeared to be the result of perineuritic adhesive arachnoiditis. Although no surgical interventions were carried out in our patients, medical or surgical intervention may be useful to prevent or relieve constrictive arachnoiditis and preserve vision in selected patients.- - - - - - - - - - ranking = 2keywords = meningitis (Clic here for more details about this article) |
14/28. Intracranial complications of submucous resection of the nasal septum.Submucous resection of the nasal septum (SMR) is a relatively simple and frequently performed operation. Yet, its intracranial complications, although rare, can be very serious and include anosmia, visual disturbances, cavernous sinus thrombosis, meningitis, cerebrospinal fluid rhinorrhea, pneumocephalus, subarachnoid hemorrhage, subdural empyema, and brain abscess. This article reviews intracranial complications of SMR, and the pathogenesis and prevention of such complications are discussed.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
15/28. Visual loss in cryptococcal meningitis.Optic neuropathy with visual loss is a well-known complication of chronic elevated intracranial pressure. The association of visual loss with cryptococcal meningitis may reflect the intracranial hypertension often seen in this condition. However, the generally poor results of optic nerve sheath fenestration and analysis of autopsy cases have led to the suggestion that direct invasion of the visual system by organisms may be the more common mechanism of visual loss. We describe a patient with severe visual loss from cryptococcal meningitis in whom organisms were demonstrated in the optic nerve sheath obtained at the time of fenestration. This is the first report to demonstrate this finding in a living patient.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
16/28. Recurrent sterile meningitis caused by a pituitary abscess.The case of a 21 year old woman who presented with recurrent sterile meningitis and bitemporal hemianopia is described. Computed tomographic scan showed a large low density ring enhancing lesion above and within the pituitary fossa which at operation and on histological examination was found to be compatible with an abscess. The visual field defect recovered completely and the scan appearances returned to normal postoperatively.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
17/28. Symptomatic Rathke's cleft cysts. Report of two cases.Two unusual cases of symptomatic Rathke's cleft cysts are described. The first patient was a 47-year-old man who presented with recurrent aseptic meningitis in addition to visual symptoms, panhypopituitarism, and hydrocephalus. The second patient was a 41-year-old man presenting with increasing headache, and a large, nonenhancing sellar cyst showing suprasellar extension on computerized tomography. The similarities between Rathke's cleft cysts and craniopharyngiomas are discussed.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
18/28. Cryptococcal meningitis with severe visual and hearing loss and radiculopathy in a patient without immunodeficiency.cryptococcosis is an important cause of lymphocytic meningitis, especially but not necessarily in immunocompromised patients. We present the case of a 23-year-old man with a severe and rapid course of a cryptococcal meningoencephalitis, which led to visual and hearing loss, psychotic illness and radiculopathy. There was no evidence of immunodeficiency. Treatment with amphotericin b and flucytosine led to improvement of the symptoms but did not eradicate the micro-organisms from the cerebrospinal fluid (CSF). maintenance therapy with fluconazole was necessary and led to improvement of the CSF pathology.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
19/28. Visual loss from idiopathic intracranial pachymeningitis.We report three patients with chronic headaches and optic neuropathy due to widespread meningeal thickening shown on enhanced MRI; all had biopsy-proven intracranial pachymeningitis (fibrosclerosis of the meninges). Two patients had bilateral optic neuropathy, elevated CSF protein, and polyclonal serum hypergammaglobulinemia. They developed temporal lobe cortical necrosis or sagittal sinus thrombosis, presumably due to compromised dural venous drainage from extensive meningeal fibrosis. The other patient had multiple cranial nerve palsies and unilateral optic neuropathy with normal CSF. Corticosteroid therapy improved visual function in all three patients, although all had persisting visual deficits. gadolinium-enhanced MRI was essential in identifying meningeal inflammation and locating suitable biopsy sites.- - - - - - - - - - ranking = 115.43887162997keywords = pachymeningitis, meningitis (Clic here for more details about this article) |
20/28. optic nerve sheath decompression for visual loss in patients with acquired immunodeficiency syndrome and cryptococcal meningitis with papilledema.Visual dysfunction developing in association with acquired immunodeficiency syndrome (AIDS) can be multifactorial. Two patients with this syndrome and cryptococcal meningitis had papilledema and visual loss. Both were treated by optic nerve sheath fenestration. One patient had bilateral nonsimultaneous optic nerve sheath fenestrations; visual function improved in one eye. The other patient had bilateral visual improvement after a unilateral optic nerve sheath fenestration. Cryptococcal organisms were present in the dural sheath specimens of both patients despite ongoing therapy with antifungal medication. Postoperative orbital infectious complications did not occur. autopsy examination of one patient showed that the sites of fenestration were patent. Medical treatment of cryptococcal meningitis associated with AIDS has a guarded prognosis. optic nerve sheath fenestration offers a treatment alternative for papilledema and visual loss that occur with cryptococcal meningitis.- - - - - - - - - - ranking = 7keywords = meningitis (Clic here for more details about this article) |
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