MRIMS Journal of Health Sciences

CASE REPORT
Year
: 2021  |  Volume : 9  |  Issue : 2  |  Page : 81--84

Asymptomatic diffuse cerebritis presenting as middle cerebral artery infarct: A case report and review of literature


Sibhi Ganapathy, J Adesh, Pratham Bysani, Jay Pandya, Rajesh R Raykar 
 Department of Neurosurgery & Spine Surgery, St. Johns' Hospital, Bangalore, India

Correspondence Address:
Dr. Sibhi Ganapathy
Assistant Professor, Department of Neurosurgery and Spine Surgery, St. John's Medical Collage and Hospital, Bangalore, Karnataka State
India

Diffuse cerebritis is a devastating disease presenting with features of raised intracranial tension, deficits, and features of meningeal and neural irritation. The most common feature is seizures which may persist despite normal antiepileptic medication. We present a patient with diffuse cerebritis who presented as a subacute middle cerebral artery (MCA) territory infarct without any symptoms of meningeal irritation or infection. The patient once admitted deteriorated with pupillary asymmetry and loss of consciousness. A computerized tomography scan revealed a massive increase in cerebral edema of the infarcted brain with midline shift and mass effect. In view of the serious threat to life, a decompressive craniectomy was done. Once the dura was opened, pus was seen subpially oozing into the subdural space. This was sampled for analysis and the scalp flap was closed with a drain. The patient improved well post surgically and was gradually extubated. His pus was found to grow Klebsiella pneumoniae sensitive to amikacin and gentamicin. A prolonged course of antibiotics was started. An angiogram done to determine the cause of the infarct showed only distal MCA branches (M4) occluded. The patient later deteriorated with venous thrombosis and succumbed to his illness later. We present a discussion on the etiology of the patient's condition and possible treatment options when faced with such situations.


How to cite this article:
Ganapathy S, Adesh J, Bysani P, Pandya J, Raykar RR. Asymptomatic diffuse cerebritis presenting as middle cerebral artery infarct: A case report and review of literature.MRIMS J Health Sci 2021;9:81-84


How to cite this URL:
Ganapathy S, Adesh J, Bysani P, Pandya J, Raykar RR. Asymptomatic diffuse cerebritis presenting as middle cerebral artery infarct: A case report and review of literature. MRIMS J Health Sci [serial online] 2021 [cited 2021 Oct 21 ];9:81-84
Available from: http://www.mrimsjournal.com/article.asp?issn=2321-7006;year=2021;volume=9;issue=2;spage=81;epage=84;aulast=Ganapathy;type=0