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A Choroid Plexus Epithelial Cell-based Model of the Human Blood-Cerebrospinal Fluid Barrier to Study Bacterial Infection from the Basolateral Side
09:58

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[A case with bacterial meningitis caused by cerebrospinal fluid rhinorrhea 22 years after head trauma]

K Tokisato1, Y Inatomi, T Yonehara

  • 1Stroke Center, Saiseikai Kumamoto Hospital.

Rinsho Shinkeigaku = Clinical Neurology
|January 26, 2002
PubMed

Insights

A past head injury can lead to delayed cerebrospinal fluid (CSF) leakage and bacterial meningitis, even decades later. Prompt diagnosis via advanced imaging is crucial for effective treatment.

Area of Science:

  • Neurology
  • Neurosurgery
  • Infectious Diseases

Background:

  • A 38-year-old male presented with bacterial meningitis.
  • He had a history of head trauma at age 16.

Observation:

  • Massive cerebrospinal fluid (CSF) rhinorrhea occurred prior to meningitis symptoms.
  • Neurological examination revealed fever, headache, and nuchal rigidity.
  • Advanced imaging (3D-CT, MPR-CT, MRI) identified a right skull base defect and frontal lobe herniation into the ethmoidal sinus.

Findings:

  • Diagnosis of CSF rhinorrhea and bacterial meningoencephalitis confirmed.
  • Symptoms resolved with antibiotic therapy.
  • No recurrence of meningitis observed.

Implications:

  • Delayed diagnosis of CSF leaks from remote head trauma is possible.
  • Comprehensive neuroimaging is vital for identifying the cause of CSF rhinorrhea and meningitis.
  • Detailed patient history, including remote head trauma, is essential for accurate diagnosis and management.

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