DELAYED CEREBRAL VASOSPASM SECONDARY TO BACTERIAL MENINGITIS AFTER LUMBOSACRAL SPINAL SURGERY

Author:

Chaichana Kaisorn1,Riley Lee H.2,Tamargo Rafael J.1

Affiliation:

1. Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland

2. Department of Orthopedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland

Abstract

Abstract OBJECTIVE Delayed cerebral vasospasm is an under-recognized complication of meningitis. This case report is important because it is the first to definitively associate vasospasm with meningitis using catheter angiography. Furthermore, it is the first to correlate the time course of delayed cerebral vasospasm with meningitis. CLINICAL PRESENTATION We present a patient who developed a partial expressive aphasia 9 days after developing meningitis, consistent with cerebral vasospasm, after lumbosacral spinal surgery. INTERVENTION Vasospasm was confirmed by angiography and transcranial Doppler sonography, and symptoms responded to hypervolemia, hypertension, and hemodilution therapy. CONCLUSION If a patient develops neurological symptoms consistent with a timeline of delayed cerebral vasospasm in the setting of meningitis, angiographic evaluation and appropriate therapy should be pursued.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Clinical Neurology,Surgery

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4. The effect of hemodilution on cerebral blood flow velocity in anesthetized patients;Bruder;Anesth Analg,1998

5. Inhibition of vasospasm with lymphocyte function-associated antigen-1 monoclonal antibody in a femoral artery model in rats;Clatterbuck;J Neurosurg,2002

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