1/234. clostridium perfringens: a rare cause of postoperative spinal surgery meningitis.BACKGROUND: clostridium perfringens is a rare cause of central nervous system infections, particularly meningitis. The case of a 76-year-old man who developed fatal C. perfringens meningitis after routine decompressive laminectomy for spinal stenosis is described. CASE REPORT: Twelve days after surgery the patient presented with pain and serosangiunous drainage from the surgical incision site. A swab of the drainage revealed Gram-positive bacilli; MRI of the lumbosacral spine showed the appearance of air around the laminectomy site. The patient died within 6 hours of presentation. autopsy revealed acute cranial and spinal meningitis and choroid plexitis with organisms consistent with C. perfringens. CONCLUSION: No significant enteral pathology or source of endogenous infection was determined, suggesting postoperative wound contamination and meningeal seeding with this ubiquitous organism. Clostridial infection, although rare, should be considered in any patient with meningitis with a history of surgical intervention. survival with minimal neurological deficits was achieved in half of the previously reported cases.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
2/234. Unusual presentation and course of hiv-1 progressive encephalopathy.The present report concerns a vertically human immunodeficiency virus type 1 (hiv-1)-infected 7-year-old child, in whom a neurodegenerative disease occurred after an acute neurologic disorder that was in all likelihood symptomatic of hiv-1 encephalitis. At the steady state the neurologic disease fulfilled the accepted criteria of HIV-related progressive encephalopathy of childhood and was characterized by involvement of multiple neural systems and subcortical dementia. The neurologic disease displayed, however, atypical presentation and course, and its acute focal onset led the authors to postulate an acute and direct involvement of the brain in hiv-1 infection. The correlation between the cliniconeuroradiologic data and levels of HIV-rna in the cerebrospinal fluid and the response to different antiretroviral treatments are also discussed.- - - - - - - - - - ranking = 0.11583178292448keywords = brain (Clic here for more details about this article) |
3/234. 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 = 0.11583178292448keywords = brain (Clic here for more details about this article) |
4/234. 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 = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
5/234. 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 = 0.11583178292448keywords = brain (Clic here for more details about this article) |
6/234. A magnetic resonance abnormality correlating with permeability of the blood-brain barrier in a child with chemical meningitis during central nervous system prophylaxis for acute leukemia.Chemical meningitis developed in a boy with acute lymphoblastic leukemia during central nervous system (CNS) prophylaxis. cerebrospinal fluid examination showed pleocytosis and a high protein level. There were no malignant cytological findings. Calculated permeability of albumin across the blood-brain barrier (BBB) was more elevated than that of immunoglobulin or alfa2-macroglobulin. magnetic resonance imaging (MRI) revealed diffuse pachymeningeal enhancement without any intracerebral lesion. Subsequent CNS prophylaxis was postponed. CSF findings and BBB permeability returned to normal, correlating well with the decrease of MRI abnormality.- - - - - - - - - - ranking = 5.5791589146224keywords = central nervous system, nervous system, brain (Clic here for more details about this article) |
7/234. The treatment of meningitis in infants with co-trimoxazole administered parenterally.We found that co-trimoxazole had a good clinical and antibacterial effect when given parenterally to infants with infections of the central nervous system. We showed good concentrations in the serum and satisfactory penetrations into the cerebrospinal fluid. In one case, there was a side effect which may have been due to the sulpha or to the solvent. We think that at present the preparation should not be given to very premature babies or to babies with icterus, for the same reasons that we avoid using sulpha preparations in these conditions, but otherwise it may be of great use in difficult cases of meningitis caused by gram-negative bacteria in infancy.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
8/234. Idiopathic hypertrophic cranial pachymeningitis with perifocal brain edema--case report.A 51-year-old female presented with an extremely rare case of idiopathic hypertrophic cranial pachymeningitis manifesting as markedly thickened frontotemporal meninges with expanding perifocal edema. magnetic resonance imaging with gadolinium revealed enhancement of the thickened dura mater protruding into the brain parenchyma accompanied by focal edema causing a mass effect. Histological examination of a biopsy specimen revealed thickened dura with infiltrating lymphocytes. Serological and immunological tests were normal. No inflammatory response or evidence of malignant tumors was observed. The patient was treated with predonisolone, resulting in marked improvement of the mass effect. High-dose steroid therapy appears to be effective for intracranial pachymeningitis associated with expanding perifocal brain edema.- - - - - - - - - - ranking = 0.69499069754689keywords = brain (Clic here for more details about this article) |
9/234. Pachymeningitis in microscopic polyangiitis (MPA): a case report and a review of central nervous system involvement in MPA.A case of microscopic polyangiitis (MPA) with pachymeningitis is described. The patient had renal, skin, gallbladder and peripheral nervous system involvement, simultaneously with pachymeningitis. Necrotizing glomerulonephritis with crescent formation, and necrotizing small vessel vasculitis in the kidney and skin were confirmed by biopsy. A highly elevated titer of antineutrophil cytoplasmic antibody for myeloperoxidase (MPO-ANCA) was observed. All of the clinical and laboratory abnormalities improved with high-dose pulse and conventional steroid therapy. The literature on central nervous system involvement in MPA and perinuclear-ANCA (p-ANCA)-related vasculitis is reviewed. This case serves to emphasize that pachymeningitis can occur as one of the features of MPA.- - - - - - - - - - ranking = 5.2726209894216keywords = central nervous system, nervous system (Clic here for more details about this article) |
10/234. P-ANCA-positive Wegener's granulomatosis presenting with hypertrophic pachymeningitis and multiple cranial neuropathies: case report and review of literature.An autopsy case of hypertrophic pachymeningitis and multiple cranial neuropathies is reported. A 53-year-old woman with paraplegia and various neurological signs which developed over a 2 year period was diagnosed as having an epidural mass with thickened dura mater extending from the lower cervical to the thoracic spinal cord. In addition, bilateral episcleritis, blephaloptosis, and blindness of the right eye with various cranial nerve deficits were found to be caused by the mass lesions involving the paranasal sinuses, orbit, and the cavernous sinus. Perinuclear antineutrophil cytoplasmic antibody (p-ANCA) was positive, but cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA) was negative by enzyme-linked immunosorbent assay. The partially removed epidural mass with hypertrophied dura mater and biopsy of the paranasal lesions showed chronic granulomatous inflammation with vasculitis. The remaining lesions resolved with steroid therapy with remarkable neurological improvement. The positive p-ANCA test, paranasal involvement, the report of a similar histopathological case and a review of the literature on granulomatous pachymeningitis suggest the presence of p-ANCA-positive Wegener's granulomatosis with central nervous system involvement characterized by hypertrophic pachymeningitis and/or multiple cranial neuropathies.- - - - - - - - - - ranking = 1keywords = central nervous system, nervous system (Clic here for more details about this article) |
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