Cervicomedullary Injury After Pneumococcal Meningitis With Brain Edema

摘要: Objectives To demonstrate a rare but potential mechanism of quadriplegia in patient with fulminant pneumococcal meningitis complicated by severe intracranial hypertension. Design Case report. Setting Intensive care unit. Patient A 21-year-old man who presented 3 days headache, combativeness, and fever. Intervention Antibiotics steroids were initiated after lumbar puncture yielded purulent cerebrospinal fluid streptococcus pneumoniae. Results The patient's course was cerebral edema necessitating pressure monitoring pressure–targeted therapy. Within 5 he developed areflexia. Brain cervical spine magnetic resonance imaging revealed patchy areas T2 signal hyperintensity associated gadolinium enhancement the superior spinal cord, cerebellar tonsils, medulla. Conclusions Quadriplegia secondary to tonsillar herniation is should be considered patients acute quadriparesis treatment increased pressure. Magnetic changes may demonstrated. Significant improvement cord symptoms can expected.