두부외상 후 발생한 뇌척수액 비루를 동반한 폐구균 뇌막염 1례

A Case of Pneumococcal Meningitis Associated with Posttraumatic Cerebrospinal Fluid Rhinorrhea

저자들은 두부 외상 3년 후 뇌척수액 비루를 동반한 폐구균 뇌막염이 발생한 환아에서 뇌자기 공명영상과 안면부 전산화 단층 촬영을 실시하여 우측 접형골의 골절과 우측 사골동의 골결손 부위를 확인하였으며 정맥용 항생제 치료와 보존적 치료 후 호전된 환아 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Bacterial meningitis after head trauma is a rare complication, but the cerebrospinal fluid(CSF) leakage after head trauma greatly increases the risk of bacterial meningitis. Most of the infections passes through the defects in the basal skull fracture, and Streptococcus pneumoniae is the most common organism. MRI, coronal thin sections of cranial CT and radioiosotope cisternography are considered to diagnose the CSF fistulae. We report a case of a 14-year-old girl with pneumococcal meningitis complicated by CSF rhinorrhea following an asymptomatic period of 3 years after head trauma. We found a bone defect of the cribrium of the skull base by means of paranasal sinus CT scanning and MRI.