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DOI: 10.4103/ajns.AJNS_239_17
Intracranial hemorrhage caused by bacterial meningitis: Case report and review of the literature

Hemorrhagic stroke is an extremely rare complication in bacterial meningitis. Therefore, the incidence and prognosis have not been fully clarified. In this case report, we describe a case of intracranial hemorrhage caused by bacterial meningitis, which originated from paranasal sinusitis. A man visited the hospital due to fever, nonproductive cough, and oppressive pain of cheek. He was diagnosed with purulent sinusitis and received antibiotics. However, he suddenly developed a severe headache and came to our department. Computed tomography scan revealed right subcortical hematoma. We performed hematoma evacuation, but headache and fever did not cease. From the analysis of the cerebrospinal fluid, he was diagnosed with cerebral hemorrhage caused by meningitis and treated with broad-spectrum antibiotics. Through this treatment, his condition rapidly improved. Hemorrhagic stroke is a rare complication of bacterial meningitis, but if this condition develops, then, there is a high risk of mortality and morbidity.
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Publication History
Article published online:
09 September 2022
© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Swartz MN. Bacterial meningitis: More involved than just the meninges. N Engl J Med 1984;311:912-4.
- 2 Schut ES, Lucas MJ, Brouwer MC, Vergouwen MD, van der Ende A, van de Beek D, et al. Cerebral infarction in adults with bacterial meningitis. Neurocrit Care 2012;16:421-7.
- 3 Vergouwen MD, Schut ES, Troost D, van de Beek D. Diffuse cerebral intravascular coagulation and cerebral infarction in pneumococcal meningitis. Neurocrit Care 2010;13:217-27.
- 4 Katchanov J, Heuschmann PU, Endres M, Weber JR. Cerebral infarction in bacterial meningitis: Predictive factors and outcome. J Neurol 2010;257:716-20.
- 5 Gironell A, Domingo P, Mancebo J, Coll P, Martí-Vilalta JL. Hemorrhagic stroke as a complication of bacterial meningitis in adults: Report of three cases and review. Clin Infect Dis 1995;21:1488-91.
- 6 de Souza AL, Sztajnbok J, Seguro AC. Cerebellar hemorrhage as an atypical complication of meningococcal meningitis. Int J Infect Dis 2008;12:558-9.
- 7 Bodilsen J, Dalager-Pedersen M, Schønheyder HC, Nielsen H. Stroke in community-acquired bacterial meningitis: A Danish population-based study. Int J Infect Dis 2014;20:18-22.
- 8 Klein M, Koedel U, Pfefferkorn T, Zeller G, Woehrl B, Pfister HW, et al. Arterial cerebrovascular complications in 94 adults with acute bacterial meningitis. Crit Care 2011;15:R281.
- 9 Durand ML, Calderwood SB, Weber DJ, Miller SI, Southwick FS, Caviness VS Jr., et al. Acute bacterial meningitis in adults. A review of 493 episodes. N Engl J Med 1993;328:21-8.
- 10 Mook-Kanamori BB, Fritz D, Brouwer MC, van der Ende A, van de Beek D. Intracerebral hemorrhages in adults with community associated bacterial meningitis in adults: Should we reconsider anticoagulant therapy? PLoS One 2012;7:e45271.
- 11 Boehme AK, Ranawat P, Luna J, Kamel H, Elkind MS. Risk of acute stroke after hospitalization for sepsis: A case-crossover study. Stroke 2017;48:574-80.
- 12 Brouwer MC, Heckenberg SG, de Gans J, Spanjaard L, Reitsma JB, van de Beek D, et al. Nationwide implementation of adjunctive dexamethasone therapy for pneumococcal meningitis. Neurology 2010;75:1533-9.
- 13 Chow FC, Marra CM, Cho TA. Cerebrovascular disease in central nervous system infections. Semin Neurol 2011;31:286-306.
- 14 Sáez-Llorens X, McCracken GH Jr. Bacterial meningitis in children. Lancet 2003;361:2139-48.