Chronic Cerebellar Meningoencephalitis in Adulthood: A Report of a Rare Case

TL;DR

This paper reports a rare case of chronic cerebellar meningoencephalitis in an adult, highlighting the diagnostic and treatment approaches used.

Contribution

The novelty lies in presenting a rare clinical case with detailed diagnostic and therapeutic insights.

Findings

MRI showed hyperintense lesions in the cerebellum, leading to surgical excision and biopsy.

Biopsy confirmed chronic meningoencephalitis, and antibiotic therapy improved symptoms.

Surgical and medical interventions proved effective in managing the disease.

Abstract

The development of meningoencephalitis is a result of an inflammation of the meninges and the brain, which can cause neurological sequelae. Cerebellar meningoencephalitis in adult patients is extremely rare and requires special diagnostic approaches. The aim of this report is to present a rare case of meningoencephalitis and evaluate the diagnostic and therapeutic techniques. We present a 45-year-old male patient who has entered the neurosurgery clinic with a severe headache lasting for a month. Neurological status determines intracranial hypertension. Magnetic resonance tomography (MRT) showed evidence of hyperintense lesions with homogenous enhancement in the right hemisphere of the cerebellum. The patient underwent a suboccipital paramedian craniotomy to excise the lesions and for the pathohistological examination of the biopsy material. Biopsy examination found sections expressing an infection process causing chronic meningoencephalitis in the right hemisphere of the cerebellum. The patient was treated postoperatively with cephalothin 2 g every 12 hours for 14 days. Follow-up examinations proved a relief of the symptoms. Meningoencephalitis of the cerebellum and the meninges is a complication that may occur in adulthood, and surgical excision, biopsy examination, and antibiotic therapy are promising methods for managing the disease.

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