AI Article Synopsis
- The case discusses a rare instance of complications from sinusitis in a healthy 19-year-old male, leading to severe neurological issues like cerebral vasospasm and ischemia.
- Treatment involved aggressive management strategies including surgical intervention and daily catheter-directed infusions to address the complications of bacterial meningoencephalitis.
- The use of CT brain perfusion scans was crucial in diagnosing delayed cerebral ischemia, highlighting the complexity of distinguishing between cerebral vasospasm and the progression of meningoencephalitis.
Article Abstract
, found as normal flora in healthy individuals, is an unusual culprit for pharyngitis and sinusitis in young adults, rarely leading to severe infections. Here, we present a singular case involving a 19-year-old immunocompetent male who experienced complications arising from sinusitis, leading to orbital and intracranial sinogenic complications. The patient developed severe cerebral vasospasm with delayed cerebral ischemia, necessitating aggressive management encompassing daily catheter-directed intra-arterial infusions, surgical source control, and maximal medical therapy. This case explores the challenging diagnostic and management aspects associated with cerebral artery vasospasm secondary to bacterial meningoencephalitis. The abrupt neurological decline in such patients presents a dilemma in recognizing the occurrence of cerebral vasospasm versus the progression of meningoencephalitis. By utilizing computed tomography brain perfusion scans, we were able to identify delayed cerebral ischemia due to cerebral vasospasm, acknowledging that this modality was not used to identify classical territorial stroke infarcts. This decision was made based on the understanding of the potential for bacterial-induced cerebral vasospasm to involve both hemispheres.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11033105 | PMC |
| http://dx.doi.org/10.1016/j.radcr.2024.03.029 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Clazosentan's dual edge in managing vasospasm following aneurysmal subarachnoid hemorrhage: an updated systematic review, meta-analysis, and meta-regression of clinical outcomes and safety profiles.
Neurosurg Rev
January 2025
Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
Aneurysmal Subarachnoid Hemorrhage (aSAH), resulting from ruptured aneurysms, is a major contributor to stroke-related mortality and morbidity. Despite advances in healthcare, aSAH remains severe and often leads to complications such as cerebral vasospasm (CV), cerebral infarction, and delayed ischemic neurological deficits (DIND). Clazosentan, an endothelin receptor antagonist, has demonstrated potential in alleviating vasospasm and its associated outcomes, although evidence of its efficacy remains unclear.
View Article and Find Full Text PDFEndovascular Treatment of Mirror Aneurysms in Subarachnoid Hemorrhage Patients: Single Stage or Multiple Stage?
Brain Behav
January 2025
Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China.
Objective: The study evaluated the effectiveness and safety of single-stage versus multistage endovascular treatment in subarachnoid hemorrhage patients with Mirror Aneurysms.
Materials And Methods: Our research team performed a prospective study, focusing on the radiographic and clinical data of patients diagnosed with subarachnoid hemorrhage, specifically those who presented with Mirror Aneurysms upon admission to our institutions. According to the different endovascular treatment stages, these patients were grouped into the multistage cohort and the single-stage cohort.
Reversible cerebral vasoconstriction syndrome in a methylphenidate-treated patient: a case report.
BMC Neurol
December 2024
Pharmacovigilance, Pharmacoepidemiology and Drug Information Centre, Department of Clinical Pharmacology, Rennes University Hospital, Rennes, 35033, France.
Background: Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by severe headaches, often thunderclap headaches, and a multifocal constriction of the cerebral arteries. Although RCVS can occur spontaneously, some cases occur after exposure to drugs. We describe the first case of RCVS in which methylphenidate, a drug with vasoconstrictive properties, is the only suspected drug.
View Article and Find Full Text PDFIntrathecal Nicardipine After Aneurysmal Subarachnoid Hemorrhage: A Scoping Review.
Neurocrit Care
December 2024
Department of Neurology, Albany Medical Center, Albany, NY, USA.
Intrathecal nicardipine (ITN) is an investigational therapy for cerebral vasospasm (CVS) and delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH). The objective of this scoping review was to characterize the current state of the literature and map the current available evidence, examine research methodology, clarify key concepts and definitions in the literature, report procedural characteristics, identify and analyze knowledge gaps, and serve as a precursor for future systematic reviews, meta-analyses, and randomized controlled trials. An electronic search for studies on ITN for the treatment of CVS and DCI in patients with aSAH was conducted in accordance with published standards.
View Article and Find Full Text PDFSafety and efficacy of staged primary coiling followed by delayed flow diversion of ruptured intracranial aneurysms: A systematic review and meta-analysis.
Interv Neuroradiol
December 2024
Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, FL, USA.
Background: Ruptured intracranial aneurysms lead to significant mortality and morbidity. Recent advancements have suggested staged coiling with subsequent flow diverter stent placement may reduce the risk of hemorrhage with dual antiplatelet therapy (DAPT) or stent thrombosis in the acute inflammatory phase after aneurysm rupture while still appropriately mitigating risk of aneurysmal rehemorrhage.
Materials And Methods: A systematic review and single-arm meta-analysis was conducted.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!