TY  - JOUR
T1  - MEningococcal meningitis with brainstem infarction
AU  - van de Beek D, Patel R, Wijdicks EM
Y1  - 2007/09/01
N1  - 10.1001/archneur.64.9.1350
JO  - Archives of Neurology
SP  - 1350
EP  - 1351
VL  - 64
IS  - 9
N2  - 
A 25-year-old woman was admitted with confusion, headache, and vomiting. Physical examination showed disorientation to time and place, difficulty following commands, and neck stiffness. Lumbar puncture revealed a cerebrospinal fluid (CSF) leukocyte count of 0.674/μL and a low CSF–blood glucose ratio. Ceftriaxone sodium administration was started empirically; CSF cultures grew Neisseria meningitidis. The second day, a sudden respiratory arrest occurred. No seizures were noted. Computed tomography revealed dilatation of the entire ventricular system, indicating communicating hydrocephalus (Figure). A right frontal external ventricular drain was placed for 5 days. The patient's confusion resolved after CSF drainage; however, a mild right hemiparesis and a right-sided Horner syndrome were noticed. Magnetic resonance imaging showed a focal zone of signal abnormality in the right dorsal aspect of the medulla oblongata, which had restricted diffusion, suggestive of cerebral infarction (Figure). Hemiparesis gradually improved over the course of hospitalization, but some numbness of the right hand remained.

SN  - 0003-9942
M3  - doi: 10.1001/archneur.64.9.1350
UR  - http://dx.doi.org/10.1001/archneur.64.9.1350
ER  -