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[A case of pneumococcal meningitis with reversible arterial stenosis]

Shinji Kitsuki1, Kenji Fukuda1, Tomonaga Matsushita1

  • 1Department of Cerebrovascular Medicine, Saint Maria Hospital.

Rinsho Shinkeigaku = Clinical Neurology
|June 16, 2020
PubMed

Insights

Pneumococcal meningitis can cause serious complications like cerebral infarction and arterial stenosis. Vasospasm may play a role in the vascular stenosis observed during treatment, highlighting the need for careful monitoring.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Vascular Medicine

Background:

  • Pneumococcal meningitis is a severe bacterial infection affecting the central nervous system.
  • Treatment typically involves antibacterial drugs and corticosteroids.
  • Neurological complications, including vascular events, can arise during the course of meningitis.

Observation:

  • A 72-year-old male with pneumococcal meningitis experienced decreased consciousness on day 6.
  • Diffusion-weighted imaging (DWI) MRI on day 7 revealed new bilateral cerebellar infarction.
  • Magnetic resonance angiography (MRA) and CT angiography showed progressive multiple arterial stenosis.

Findings:

  • Cerebral infarction expanded, and diffuse arterial stenosis worsened by day 12.
  • The observed vascular stenosis gradually improved, resolving by day 39.
  • The temporal progression suggests vasospasm as a potential contributing factor to vascular stenosis.

Implications:

  • Vasospasm may be implicated in the pathogenesis of vascular stenosis secondary to pneumococcal meningitis.
  • These findings underscore the importance of vigilant neuroimaging and monitoring for vascular complications.
  • Further research into the mechanisms of meningitis-associated vasospasm is warranted.
Keywords:
multiple cerebral infarctionpneumococcal meningitisvasculitisvasospasm

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