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2015 ; 6
(ä): 148
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A multidisciplinary approach to the treatment of severe cerebral vasospasm
following bacterial meningitis: A case report and literature review
#MMPMID26487973
Nussbaum ES
; Lowary J
; Nussbaum LA
Surg Neurol Int
2015[]; 6
(ä): 148
PMID26487973
show ga
BACKGROUND: Although cerebrovascular complications of bacterial meningitis are
common, postmeningitic cerebral vasospasm significant enough to result in
ischemic injury has been reported in only limited fashion. CASE DESCRIPTION: We
describe a case of severe cerebral vasospasm following streptococcal meningitis
managed successfully with emergency suboccipital decompression,
extracranial-intracranial bypass, intra-arterial vasodilator infusion, and
maximal medical therapy. To our knowledge, this may be the first case in which
surgical cerebral revascularization has been utilized to limit ischemic injury in
the setting of postmeningitic cerebral vasospasm. CONCLUSIONS: Patients
presenting with abrupt neurological decline following recent treatment for
bacterial meningitis may be suffering from a reversible vasoconstriction of the
cerebral arteries, and prompt aggressive treatment can result in a favorable
outcome even in patients who present in very poor neurological condition.