| Cervicomedullary injury after pneumococcal meningitis with brain edema. | |
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MedLine Citation:
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PMID: 21482931 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVES: To demonstrate a rare but potential mechanism of quadriplegia in a patient with fulminant pneumococcal meningitis complicated by severe intracranial hypertension. DESIGN: Case report. SETTING: Intensive care unit. Patient A 21-year-old man who presented with 3 days of headache, combativeness, and fever. Intervention Antibiotics and steroids were initiated after lumbar puncture yielded purulent cerebrospinal fluid and streptococcus pneumoniae. RESULTS: The patient's course was complicated by severe cerebral edema necessitating intracranial pressure monitoring and intracranial pressure-targeted therapy. Within 5 days he developed quadriplegia and areflexia. Brain and cervical spine magnetic resonance imaging revealed patchy areas of T2 signal hyperintensity with associated gadolinium enhancement in the superior cervical spinal cord, cerebellar tonsils, and medulla. CONCLUSIONS: Quadriplegia secondary to tonsillar herniation in fulminant meningitis is rare but should be considered in patients with acute quadriparesis after treatment of increased intracranial pressure. Magnetic resonance imaging signal changes and gadolinium enhancement may be demonstrated. Significant improvement of cord symptoms can be expected. |
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Authors:
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Rajanandini Muralidharan; Alejandro A Rabinstein; Eelco F M Wijdicks |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Archives of neurology Volume: 68 ISSN: 1538-3687 ISO Abbreviation: Arch. Neurol. Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-04-12 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372436 Medline TA: Arch Neurol Country: United States |
Other Details:
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Languages: eng Pagination: 513-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Neurology, Mayo Clinic, W8B, 200 First St SW, Rochester, MN 55905. wijde@mayo.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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