Kobayashi Toshiyuki, Tadokoro Hiroshi, Odai Tsuyoshi, Hibino Takenori, Waki Kanami
Department of General Medicine, Ebina General Hospital, Japan.
Intern Med. 2015;54(22):2935-8. doi: 10.2169/internalmedicine.54.5010. Epub 2015 Nov 15.
Among patients with bacterial meningitis, a cerebral vasospasm typically occurs during the acute phase. We experienced a case of delayed cerebral vasospasm with infarction that was secondary to Listeria monocytogenes meningitis. An 82-year-old woman with Listeria monocytogenes meningitis, whose symptoms had been improving after the initiation of antibacterial therapy, fell into a coma on day 15 and developed generalized seizure. Magnetic resonance imaging (MRI) and MR angiography (MRA) indicated a cerebral vasospasm with multiple infarctions. The risk of vascular complications following acute bacterial meningitis requires close follow-up to identify neurological changes and a low threshold for vascular evaluation. In such cases, MRI and MRA have diagnostic utility.
在细菌性脑膜炎患者中，脑血管痉挛通常发生在急性期。我们遇到一例继发于单核细胞增生李斯特菌脑膜炎的迟发性脑血管痉挛伴梗死病例。一名患有单核细胞增生李斯特菌脑膜炎的82岁女性，在开始抗菌治疗后症状有所改善，但在第15天陷入昏迷并出现全身性癫痫发作。磁共振成像（MRI）和磁共振血管造影（MRA）显示脑血管痉挛伴多处梗死。急性细菌性脑膜炎后发生血管并发症的风险需要密切随访以发现神经学变化，并且进行血管评估的阈值要低。在这种情况下，MRI和MRA具有诊断价值。
