[A case of cerebral arteritis secondary to bacterial meningitis]

A 34-year-old female with Streptococcus pneumonia meningitis is presented. She deteriorated suddenly and CT scan revealed low density on the right basal ganglia and left centrum semiovale. Angiographic manifestations included arterial stenosis of the supraclinoid portion of ICA and the proximal portion of MCA. Systemic and intrathecal injections of the antibiotics were done and the treatments to the cerebral infarction were added but she became vegetative. During her clinical course hydrocephalus and hemorrhagic infarction occurred. The second angiography 4 months later showed no disappearance of the findings on the initial study. Arterial stenosis due to the cerebral arteritis with meningitis had been said to be caused by inflammatory change of the arterial wall, vasospasm and contrast media. It suggests by serial cerebral angiography that arterial stenosis is due not to vasospasm, but to the inflammatory change of the arterial wall.