Reactions 1251 - 9 May 2009

SBupivacaine

Meningitis complicated with sinus venousthrombosis and intracranial haemorrhages: casereport

A 26-year-old man developed meningitis complicatedwith sinus venous thrombosis and multiple intracranialhaemorrhages following spinal anaesthesia withbupivacaine.

The man was hospitalised for diagnostic arthroscopy. Hereceived spinal anaesthesia with bupivacaine 15mg at theL3–L4 level. He developed meningitis with sinus venousthrombosis and multiple intracranial haemorrhages [timeto reaction onset not stated]. Non-contrast brain CT scanshowed multiple acute parenchymal haemorrhagesinvolving both hemispheres and effaced ventricles.Contrast brain CT scan showed filling defects in duralsinuses and increased meningeal enhancement. CT scanfindings and CSF appearance and analysis were consistentwith infectious meningitis.

The man received ceftazidime and vancomycin. He alsoreceived phenytoin, which effectively controlled hisseizures. He progressively recovered and regainedconsciousness. His upper and lower extremity motorfunction also improved. After 6 weeks of hospitalisation, hehad fully recovered without neurological deficit and wasdischarged.Mekonnen D, et al. Meningitis complicated with sinus venous thrombosis andintracranial hemorrhage in a patient who received bupivacaine spinal anesthesia.Ethiopian Medical Journal 46: 277-280, No. 3, Jul 2008 - Ethiopia 801141003

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Reactions 9 May 2009 No. 12510114-9954/10/1251-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved