Usefulness of MRA in an infant with cerebral infarction due to streptococcal meningitis

• Published in: No to hattatsu Vol. 28; no. 6; p. 520
• Main Authors: Tanabe, T, Morimoto, T, Kawasaki, Y, Yoden, A, Yoshikawa, K, Oguni, T, Yamashiro, K, Mimaki, T, Mino, M
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.11.1996
• Subjects: Cerebral Infarction - diagnosis; Cerebral Infarction - etiology; Humans; Infant; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Male; Meningitis, Bacterial - complications; Streptococcal Infections - complications
• ISSN: 0029-0831
• DOI: 10.11251/ojjscn1969.28.520

We described a 4-month-old boy with cerebral infarction due to streptococcal meningitis. He complained of cough and high fever for 2 days. On the next day he admitted to our hospital because of bad humor, drowsiness, and vomiting associated with high fever, respiratory failure and loss of consciousness. On admission, he had opisthotonic posturing, anisocoria and elevated deep tendon reflexes with left side dominance. The cerebrospinal fluid showed increased cells (564/mm3), protein (295 mg/dl), and decreased sugar (1 mg/dl). Streptococcus pneumoniae was detected in the cerebrospinal fluid. Despite intensive treatment by antibiotics, glycerol, and dexamethasone, general condition was worsened, MRI showed a high intense area along the territory of bilateral anterior cerebral arteries and left middle cerebral artery 3-D time-of-flight MRA revealed a decreased signal of these arteries, confirming cerebral infarction. Recanalization of the arteries were observed 17 days after the first MRA examination. Since complication of cerebral infarction influences the prognosis of meningitis, repetitive MRA is very beneficial in patients with bacterial meningitis in order to evaluate the vascular lesion.