Meningitis from mastoiditis resulting in death

Case contributed by A.Prof Frank Gaillard

Presentation

Altered conscious state.

Patient Data

Age: 25 years
Gender: Male

Note complete opacification of the middle ear and mastoid air cells on the right. No other focal abnormality. 

One day later

Modality: CT
Modality: MRI
Modality: DSA (angiography)

Case Discussion

There is complete opacification of the middle ear and mastoid air cells on the right, which has resulted in meningitis. 

Note on the initial CT the presence of a thin subdural collection over the right hemisphere. 

Abnormal CSF is best seen on MRI (2 days later) which demonstrates extensive abnormal high signal in the CSF space on FLAIR. Multiple infarcts are also developing, the largest in the left parietal lobe. 

Patient deteriorated with progressive brain swelling and was eventually had a cerebral angiogram which demonstrates no flow in the supraclinoid portions of the internal carotid arteries or intradural vertebral arteries. He was pronounced brain dead 

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Case Information

rID: 10688
Case created: 5th Sep 2010
Last edited: 17th Nov 2015
Inclusion in quiz mode: Included

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