Hoque Romy, Gonzalez-Toledo Eduardo, Jaffe Stephen L
Department of Neurology, Louisiana State University School of Medicine-Shreveport, Shreveport, LA 71103, USA.
South Med J. 2008 Dec;101(12):1255-7. doi: 10.1097/SMJ.0b013e318183468a.
A 50-year-old man presented with progressive visual loss, headache, and two days of confusion. A computed tomography of his head suggested subarachnoid hemorrhage with accompanying right parietal ischemic infarction. The magnetic resonance image was consistent with right parietal perisulcal pial and superficial cortical inflammation; a subjacent vasogenic edema with a 1 cm diameter abscess was also present. Funduscopy revealed bilateral multifocal choroidal lesions and retinal perivascular sheathing. He was diagnosed with pseudosubarachnoid hemorrhage secondary to cryptococcal meningitis and choroidal microabscesses with retinal inflammation after a cerebrospinal fluid (CSF) examination revealed cryptococcal yeast forms, as well as high titers of CSF cryptococcal antigen, but no CSF red blood cells.
一名50岁男性出现进行性视力丧失、头痛，并伴有两天的意识模糊。其头部计算机断层扫描显示蛛网膜下腔出血伴右侧顶叶缺血性梗死。磁共振成像显示与右侧顶叶脑沟周围软脑膜和浅表皮质炎症一致；还存在直径1厘米的脓肿下方的血管源性水肿。眼底镜检查发现双侧多灶性脉络膜病变和视网膜血管周围鞘膜。脑脊液检查发现隐球菌酵母形式以及高滴度的脑脊液隐球菌抗原，但无脑脊液红细胞，因此他被诊断为继发于隐球菌性脑膜炎的假性蛛网膜下腔出血以及伴有视网膜炎症的脉络膜微脓肿。
