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We describe the clinical and pathological findings in a young man who presented with pontine infarction as an early manifestation of bacterial meningitis.Streptococcus milleri,and unusual organism in this setting,was cultured.Despite improvement with antibiotic therapy,the patient experienced fatal subarachnoid hemorrhage.A ruptured inflammatory aneurysm of the basilar artery,evidence of residual meningitis and vasculitis,and basilar thrombosis associated with pontine infarction were found. Conclusions:Bacterial meningitis,which may be associated with serve vasculopathy of the basilar artery and lead to cerebral infarction, aneurysm formation,and subarachnoid hemorrhage,should be considered in the differential diagnosis of these conditions.The role of S.milleri in meningitis and its vascular complications merits further study. |
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aneurysm aneurysm,intracranial basilar artery occlusion brainstem,infarction of cerebrovascular accident meningitis meningitis,bacterial meningitis,factors influencing mortality in meningitis,neurologic aspects and complications of mortality pons,infarction of prognosis subarachnoid hemorrhage vasculitides
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