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Santiago Palacio, MD; Robert G. Hart, MD; Dennis G. Vollmer, MD; Kathleen Kagan-Hallet, MD

Arch Neurol. 2003;60:431-433.

Background  Although vasculopathy is a recognized complication during acute meningitis, to our knowledge, no previous reports have been published of this phenomenon developing months after successful treatment.

Objective  To report a unique case of a late-developing vasculopathy after pyogenic meningitis in an adult.

Report of a Case  A 51-year-old woman was seen with severe headache 2 months after treatment of Haemophilus influenzae type C meningitis. Initial arteriography showed no abnormality; a second arteriogram showed progressive multifocal intracranial stenosis affecting mainly the internal carotid arteries. Findings from pathologic examination disclosed diffuse collagenosis consistent with chronic vascular injury from meningitis. The arterial lesions stabilized, and the patient remained asymptomatic.

Conclusion  Progressive intracranial arterial stenosis can evolve months after meningitis and should be added to the list of recognized vascular complications.

From the Departments of Medicine (Neurology) (Drs Palacio and Hart), Neurosurgery (Dr Vollmer), and Pathology (Neuropathology) (Dr Kagan-Hallet), University of Texas Health Sciences Center, San Antonio.

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