Bacterial meningitis - septation of subarachnoid spaces

Case contributed by Ammar Haouimi
Diagnosis almost certain


Status epilepticus with altered consciousness in a baby under treatment for cerebral infection.

Patient Data

Age: 2 months
Gender: Female

The MRI sequences demonstrate:

  • diffuse and extensive thickening with enhancement of the leptomeningeal structures​

  • moderate enlargement with internal septation of the subarachnoid spaces

  • mild dilatation of the 3rd and lateral ventricles

No abscess formation or subdural empyema is seen.

Case Discussion

MRI features most consistent with extensive meningitis with internal septation of the subarachnoid spaces.

This baby was treated for bacterial meningitis (culture-proven for Escherichia coli) and developed antibiotic resistance with status epilepticus.

The internal septation of the subarachnoid spaces is usually seen in the complication phase of bacterial meningitis (including tuberculous origin) with hydrocephalus due to an obstruction at the level of the aqueduct of Sylvius or the 4th ventricle.

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