Intracranial aneurysms associated with bacterial meningitis

Ojemann, R. G.; New, Paul F. J.; Fleming, Thomas C.

doi:10.1212/wnl.16.12.1222

Cited by 33 publications

(6 citation statements)

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“…In these cases, the infection probably spreads from the adventitia toward the internal elastic lamina, weakening the vessel wall, with subsequent formation of an infectious aneurysm. 23 Bacterial aneurysms of the extravascular type are extremely rare in TBM, and we were able to find only two previous cases. Suwanwela et al 24 reported postmortem findings in a patient with multiple calcined aneurysms, one fusiform involving the anterior cerebral artery and three of a saccular type located in the middle, anterior, and posterior cerebral arteries.…”

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confidence: 79%

“…All originated at sites in which basal exudates were plentiful. Another case was described by Brown 23 in a patient with an aneurysm in the basilar and upper cerebellar arteries adjacent to a tuberculoma. Since angiography is not performed routinely in TBM pa- Group I, with cerebral infarction determined by computed tomography; Group n, no evidence of infarction.…”

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confidence: 95%

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Ischemic infarction in 25 children with tuberculous meningitis.

Leiguarda

Starkstein

et al. 1988

Stroke

126

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Twenty-five cases (38%) of ischemic infarction occurred among 65 cases of tuberculous meningitis in patients <14 years of age. The male •' female ratio was 1.3:1. The most frequent clinical findings were meningeal signs, fever, alteration of consciousness, cranial nerve involvement, seizures, and focal neurologic deficit. Twenty-three patients had anterior circulation infarcts, and two more had infarcts in the vertebrobasilar territories. Distribution of infarcts in the anterior circulation was shown by computed tomography in the territories of the following arteries: lenticulostriate, 10 cases unilateral and 6 bilateral; middle cerebral, 3 cases; internal carotid, 1 case; multiple areas, 3 cases. Of the 25 ischemic infarction cases, 23 (92%) had hydrocephalus, 19 (76%) basal exudates, and 2 (8%) tuberculomas. Outcome was poor since no patient with infarction recovered completely. Six died and bilateral subcortical infarcts led to a considerably higher mortality than unilateral ones, whether cortical or subcortical. (Stroke 1988; 19:200-204)

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confidence: 79%

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confidence: 95%

Ischemic infarction in 25 children with tuberculous meningitis.

Leiguarda

Starkstein

et al. 1988

Stroke

126

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“…We have been able to find four ceases (2,14,16,10) in the English literature of such etiology and are able to add one of our own. Aneurysms caused by an intracranial but extravascular infection have on the other hand been rarely reported.…”

Section: Introductionmentioning

confidence: 73%

Mycotic aneurysms following purulent meningitis

Hannesson

Sachs

1971

Acta neurochir

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“…14 Meningitis due to Mycobacterium and Aspergillus is infection occasionally forms aneurysms in this fashion; however, bacterial causes remain less well described. 7 ' 16 In 1966 Ojemann et al 16 first reported angiographic evidence of aneurysm formation in distal branches of major cerebral vessels in a case of bacterial meningitis. Such lesions have since become well known but notably involve distant vessels rather than the circle of Willis.…”

Section: Discussionmentioning

confidence: 99%

Fatal basilar vasculopathy complicating bacterial meningitis.

Perry

Bilbao

Gray

1992

Stroke

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Bacterial meningitis complicated by thrombosis, vasculitis, and aneurysm formation affecting both small and distal branches of cerebral vessels has been well described. Involvement of major cerebral vessels is rare and has only been documented late in the course of disease. We describe the clinical and pathological findings in a young man who presented with pontine infarction as an early manifestation of bacterial meningitis. Streptococcus milleri, an unusual organism in this setting, was cultured. Despite improvement with antibiotic therapy, the patient experienced fatal subarachnoid hemorrhage. A ruptured inflammatory aneurysm of the basilar artery, evidence of residual meningitis and vasculitis, and basilar thrombosis associated with pontine infarction were found. Bacterial meningitis, which may be associated with severe vasculopathy of the basilar artery and lead to cerebral infarction, aneurysm formation, and subarachnoid hemorrhage, should be considered in the differential diagnosis of these conditions. The role of S. milleri in meningitis and its vascular complications merits further study.

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Intracranial aneurysms associated with bacterial meningitis

Cited by 33 publications

References 0 publications

Ischemic infarction in 25 children with tuberculous meningitis.

Ischemic infarction in 25 children with tuberculous meningitis.

Mycotic aneurysms following purulent meningitis

Fatal basilar vasculopathy complicating bacterial meningitis.

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