Martin H Deininger1, Ansgar Berlis, Juergen Buttler. 1. Department of General Neurosurgery, University of Freiburg Medical School, Breisacher Str. 64, Freiburg 79106, Germany. martin.deininger@uni-tuebingen.de
Abstract
OBJECTIVE: In bacterial shunt infection, CNS inflammation is a frequently observed complication that may cause vascular complications including vasospasms. Here, we describe the first patient with shunt infection-induced cerebral vasospasms. METHODS: A 35 year old woman with a ventriculoperitoneal shunt that was implanted years before developed facial nerve palsy and somnolence one week before admission to the hospital. RESULTS: After admission, the shunt was removed, and an external ventricular drainage was inserted. Microbiological analyses revealed coagulase-negative Staphylococcus on abdominal and cranial catheters. Follow-up NMR showed infarctions. Transcranial doppler sonography and cerebral arteriography revealed severe generalized cerebral vasospasms. Inspite of triple-H therapy and intraarterial spasmolysis, bilateral anterior and media artery infarction evolved. The patient was dismissed in a vegetative state. CONCLUSIONS: This case shows that severe cerebral vasospasms are a serious complication in patients with bacterial shunt infection that should be considered in patients, that don't improve following adequate antibiotic treatment.
OBJECTIVE: In bacterial shunt infection, CNS inflammation is a frequently observed complication that may cause vascular complications including vasospasms. Here, we describe the first patient with shunt infection-induced cerebral vasospasms. METHODS: A 35 year old woman with a ventriculoperitoneal shunt that was implanted years before developed facial nerve palsy and somnolence one week before admission to the hospital. RESULTS: After admission, the shunt was removed, and an external ventricular drainage was inserted. Microbiological analyses revealed coagulase-negative Staphylococcus on abdominal and cranial catheters. Follow-up NMR showed infarctions. Transcranial doppler sonography and cerebral arteriography revealed severe generalized cerebral vasospasms. Inspite of triple-H therapy and intraarterial spasmolysis, bilateral anterior and media artery infarction evolved. The patient was dismissed in a vegetative state. CONCLUSIONS: This case shows that severe cerebral vasospasms are a serious complication in patients with bacterial shunt infection that should be considered in patients, that don't improve following adequate antibiotic treatment.
Authors: M H Lebel; B J Freij; G A Syrogiannopoulos; D F Chrane; M J Hoyt; S M Stewart; B D Kennard; K D Olsen; G H McCracken Journal: N Engl J Med Date: 1988-10-13 Impact factor: 91.245
Authors: K A Popugaev; I A Savin; A U Lubnin; A S Goriachev; B A Kadashev; P L Kalinin; I N Pronin; A V Oshorov; M A Kutin Journal: Neurol Sci Date: 2011-02-03 Impact factor: 3.307