Recurrent bacterial meningitis: coronal thin-section cranial computed tomography to delineate anatomic defects.

Area of Science:

• Neurology
• Radiology
• Neurosurgery

Background:

• Recurrent bacterial meningitis presents a diagnostic challenge.
• Previous imaging and immunologic evaluations were insufficient for diagnosis in these cases.
• Standard treatments like vaccines and antibiotics were ineffective.

Observation:

• Three patients with recurrent meningitis underwent various diagnostic tests.
• Thin-section (2-mm) direct coronal computed tomography revealed anatomical defects.
• Metrizamide cisternography was not required for diagnosis.

Findings:

• All three patients had undiagnosed basiethmoidal encephaloceles.
• Direct coronal computed tomography successfully delineated these defects.
• Surgical repair of the encephaloceles was performed.

Implications:

• Thin-section direct coronal CT is a valuable, non-invasive tool for diagnosing recurrent meningitis causes.
• Identifying and surgically correcting basiethmoidal encephaloceles can resolve recurrent meningitis.
• This imaging technique improves diagnostic accuracy for complex neurological cases.