Oguri Takuya, Mitake Shigehisa, Yuasa Hiroyuki, Toyoda Takanari, Uematsu Norihiko, Miura Toshiyasu, Yoshida Mari, Hashizume Yoshio, Takada Koji, Ojika Kosei
Department of Neurology, Tosei General Hospital.
Rinsho Shinkeigaku. 2003 Jan-Feb;43(1-2):35-7.
A 79-year-old, bedridden woman with an untreated colon cancer, developed abrupt disturbance of consciousness and high fever. Brain MRI showed significant high signals in the subarachnoid space and ventricles in diffusion-weighted images (DWIs), and she died on the same day. At autopsy, much exudate was found over the base of the brain, leading to a diagnosis of purulent meningitis. On histological findings, inflammatory cell infiltration was significantly restricted within the subarachnoid space, but not into the brain parenchyma. This case report demonstrated that high signals in subarachnoid space and ventricles in DWIs may be very useful for diagnosis of purulent meningitis.
一名79岁、卧床不起且患有未治疗结肠癌的女性,突然出现意识障碍和高热。脑部磁共振成像(MRI)在弥散加权成像(DWI)中显示蛛网膜下腔和脑室有明显高信号,她于同一天死亡。尸检时,发现脑底部有大量渗出物,诊断为化脓性脑膜炎。组织学检查发现,炎症细胞浸润明显局限于蛛网膜下腔,未侵入脑实质。本病例报告表明,DWI中蛛网膜下腔和脑室的高信号可能对化脓性脑膜炎的诊断非常有用。