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[Meningitis can resemble subarachnoid haemorrhage]

Nour Foad Diab Elghoura1

  • 1Neurologisk Afdeling, Herlev Hospital, Herlev Ringvej 75, 2730 Herlev, Denmark. nour059@hotmail.com

Ugeskrift for Laeger
|May 15, 2012
PubMed

Insights

A 70-year-old man with ear pain developed meningitis due to bacteria entering the brain from acute mastoiditis. Rapid diagnosis involving CT scans and lumbar puncture is crucial for severe headaches.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Otolaryngology

Background:

  • Subarachnoid hemorrhage is a critical condition often presenting with severe headache.
  • Acute mastoiditis, an infection of the mastoid bone, can lead to serious intracranial complications.

Observation:

  • A 70-year-old male presented with symptoms mimicking subarachnoid hemorrhage, including headache, nausea, vomiting, altered consciousness, and fever.
  • Initial computed tomography (CT) revealed acute mastoiditis and pneumocephalus (air in the skull).

Findings:

  • Lumbar puncture confirmed meningitis, indicating infection of the brain's protective membranes.
  • The case suggests that increased middle ear pressure in mastoiditis allowed intracranial penetration of air and bacteria.

Implications:

  • This case highlights the necessity of a comprehensive diagnostic approach for acute onset headaches.
  • Early integration of neuroimaging (CT) and cerebrospinal fluid analysis (lumbar puncture) is vital for accurate diagnosis and timely treatment.

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