Velchev Vladislav, Burev Stefan, Yankov Dimo, Petrova Stela, Petrov Petar-Preslav, Hyusein Remzi R, Penchev Plamen
Faculty of Medicine, Medical University of Plovdiv, Plovdiv, BGR.
Department of Neurological Surgery, University Hospital "St. Ivan Rilski", Sofia, BGR.
Cureus. 2024 May 7;16(5):e59782. doi: 10.7759/cureus.59782. eCollection 2024 May.
The development of meningoencephalitis is a result of an inflammation of the meninges and the brain, which can cause neurological sequelae. Cerebellar meningoencephalitis in adult patients is extremely rare and requires special diagnostic approaches. The aim of this report is to present a rare case of meningoencephalitis and evaluate the diagnostic and therapeutic techniques. We present a 45-year-old male patient who has entered the neurosurgery clinic with a severe headache lasting for a month. Neurological status determines intracranial hypertension. Magnetic resonance tomography (MRT) showed evidence of hyperintense lesions with homogenous enhancement in the right hemisphere of the cerebellum. The patient underwent a suboccipital paramedian craniotomy to excise the lesions and for the pathohistological examination of the biopsy material. Biopsy examination found sections expressing an infection process causing chronic meningoencephalitis in the right hemisphere of the cerebellum. The patient was treated postoperatively with cephalothin 2 g every 12 hours for 14 days. Follow-up examinations proved a relief of the symptoms. Meningoencephalitis of the cerebellum and the meninges is a complication that may occur in adulthood, and surgical excision, biopsy examination, and antibiotic therapy are promising methods for managing the disease.
脑膜脑炎的发生是脑膜和脑发生炎症的结果,可导致神经后遗症。成年患者的小脑脑膜脑炎极为罕见,需要特殊的诊断方法。本报告的目的是呈现一例罕见的脑膜脑炎病例,并评估诊断和治疗技术。我们报告一名45岁男性患者,因严重头痛持续一个月而入住神经外科诊所。神经学检查确定存在颅内高压。磁共振断层扫描(MRT)显示小脑右半球有高强度病变且均匀强化。患者接受枕下旁正中开颅手术以切除病变并对活检材料进行病理组织学检查。活检检查发现切片显示在小脑右半球存在导致慢性脑膜脑炎的感染过程。患者术后每12小时用头孢噻吩2 g治疗14天。随访检查证明症状有所缓解。小脑和脑膜的脑膜脑炎是一种可能在成年期发生的并发症,手术切除、活检检查和抗生素治疗是治疗该疾病的有效方法。