Management of acute, recurrent, and chronic meningitides in adults

Neurologic Clinics

Volumn 28, Issue 4, 2010, Pages 1061-1088

  Cho, Tracey A ^a   Venna, Nagagopal ^a  

^a MASSACHUSETTS GENERAL HOSPITAL   (United States)

Author keywords

Aseptic; Bacterial; Chronic; Management; Meningitis; Viral

Indexed keywords

ACETAZOLAMIDE; ACICLOVIR; AMPHOTERICIN B; AMPICILLIN; AZTREONAM; CEFEPIME; CEFOTAXIME; CEFTAZIDIME; CEFTRIAXONE; CEPHALOSPORIN; CHLORAMPHENICOL; CIPROFLOXACIN; COTRIMOXAZOLE; DEXAMETHASONE; ETHAMBUTOL; FAMCICLOVIR; FUROSEMIDE; GENTAMICIN; ISONIAZID; LINEZOLID; MEROPENEM; NAFCILLIN; OXACILLIN; PENICILLIN G; PYRAZINAMIDE; QUINOLINE DERIVED ANTIINFECTIVE AGENT; RIFAMPICIN; UNINDEXED DRUG; VALACICLOVIR; VANCOMYCIN;

ACUTE DISEASE; ADULT; ASEPTIC MENINGITIS; BACTERIAL MENINGITIS; CHRONIC DISEASE; CLINICAL FEATURE; DIAGNOSTIC PROCEDURE; DISEASE CLASSIFICATION; DISEASE SEVERITY; FUNGAL MENINGITIS; HUMAN; HYDROCEPHALUS; LIVER TOXICITY; LYME DISEASE; MENINGITIS; MENINGOENCEPHALITIS; OPTIC NERVE DISEASE; PRIORITY JOURNAL; RECURRENT DISEASE; REVIEW; SARCOIDOSIS; SYPHILIS; TUBERCULOUS MENINGITIS; VIRUS MENINGITIS;

ACUTE DISEASE; ADULT; CHRONIC DISEASE; HUMANS; MENINGITIS;

EID: 77956233602     PISSN: 07338619     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.ncl.2010.03.023     Document Type: Review

References (120)

1. Durand M.L., Calderwood S.B., Weber D.J., et al. Acute bacterial meningitis in adults - a review of 493 episodes. N Engl J Med 1993, 328(1):21-28.
2. van de Beek D., de Gans J., Spanjaard L., et al. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med 2004, 351(18):1849-1859.
3. Attia J., Hatala R., Cook D.J., et al. The rational clinical examination. Does this adult patient have acute meningitis?. JAMA 1999, 282(2):175-181.
4. Aronin S.I., Peduzzi P., Quagliarello V.J. Community-acquired bacterial meningitis: risk stratification for adverse clinical outcome and effect of antibiotic timing. Ann Intern Med 1998, 129(11):862-869.
5. de Gans J., van de Beek D. Dexamethasone in adults with bacterial meningitis. N Engl J Med 2002, 347(20):1549-1556.
6. Hasbun R., Abrahams J., Jekel J., et al. Computed tomography of the head before lumbar puncture in adults with suspected meningitis. N Engl J Med 2001, 345(24):1727-1733.
7. Tunkel A.R., Hartman B.J., Kaplan S.L., et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 2004, 39(9):1267-1284.
8. Leib S.L., Boscacci R., Gratzl O., et al. Predictive value of cerebrospinal fluid (CSF) lactate level versus CSF/blood glucose ratio for the diagnosis of bacterial meningitis following neurosurgery. Clin Infect Dis 1999, 29(1):69-74.
9. Gerdes L.U., Jorgensen P.E., Nexo E., et al. C-reactive protein and bacterial meningitis: a meta-analysis. Scand J Clin Lab Invest 1998, 58(5):383-393.
10. Sormunen P., Kallio M.J., Kilpi T., et al. C-reactive protein is useful in distinguishing Gram stain-negative bacterial meningitis from viral meningitis in children. J Pediatr 1999, 134(6):725-729.
11. Saravolatz L.D., Manzor O., VanderVelde N., et al. Broad-range bacterial polymerase chain reaction for early detection of bacterial meningitis. Clin Infect Dis 2003, 36(1):40-45.
12. Schuchat A., Robinson K., Wenger J.D., et al. Bacterial meningitis in the United States in 1995. N Engl J Med 1997, 337(14):970-976.
13. Brouwer M.C., van de Beek D., Heckenberg S.G., et al. Community-acquired Listeria monocytogenes meningitis in adults. Clin Infect Dis 2006, 43(10):1233-1238.
14. Fong I.W., Tomkins K.B. Review of Pseudomonas aeruginosa meningitis with special emphasis on treatment with ceftazidime. Rev Infect Dis 1985, 7(5):604-612.
15. Rodriguez W.J., Khan W.N., Cocchetto D.M., et al. Treatment of Pseudomonas meningitis with ceftazidime with or without concurrent therapy. Pediatr Infect Dis J 1990, 9(2):83-87.
16. Korinek A.M., Baugnon T., Golmard J.L., et al. Risk factors for adult nosocomial meningitis after craniotomy: role of antibiotic prophylaxis. Neurosurgery 2006, 59(1):126-133. [discussion: 126-33].
17. Quagliarello V.J., Scheld W.M. Treatment of bacterial meningitis. N Engl J Med 1997, 336(10):708-716.
18. Kaufman B.A., Tunkel A.R., Pryor J.C., et al. Meningitis in the neurosurgical patient. Infect Dis Clin North Am 1990, 4(4):677-701.
19. Ratilal B., Costa J., Sampaio C. Antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures. Cochrane Database Syst Rev 2006, 1. CD004884.
20. Wen D.Y., Bottini A.G., Hall W.A., et al. Infections in neurologic surgery. The intraventricular use of antibiotics. Neurosurg Clin N Am 1992, 3(2):343-354.
21. Martinez-Lacasa J., Cabellos C., Martos A., et al. Experimental study of the efficacy of vancomycin, rifampicin and dexamethasone in the therapy of pneumococcal meningitis. J Antimicrob Chemother 2002, 49(3):507-513.
22. Paris M.M., Hickey S.M., Uscher M.I., et al. Effect of dexamethasone on therapy of experimental penicillin- and cephalosporin-resistant pneumococcal meningitis. Antimicrob Agents Chemother 1994, 38(6):1320-1324.
23. Schaad U.B., Nelson J.D., McCracken G.H. Pharmacology and efficacy of vancomycin for staphylococcal infections in children. Rev Infect Dis 1981, 3(Suppl):S282-S288.
24. Ricard J.D., Wolff M., Lacherade J.C., et al. Levels of vancomycin in cerebrospinal fluid of adult patients receiving adjunctive corticosteroids to treat pneumococcal meningitis: a prospective multicenter observational study. Clin Infect Dis 2007, 44(2):250-255.
25. Tunkel A.R., Glaser C.A., Bloch K.C., et al. The management of encephalitis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 2008, 47(3):303-327.
26. Hanson K.E., Reckleff J., Hicks L., et al. Unsuspected HIV infection in patients presenting with acute meningitis. Clin Infect Dis 2008, 47(3):433-434.
27. Nowak D.A., Boehmer R., Fuchs H.H. A retrospective clinical, laboratory and outcome analysis in 43 cases of acute aseptic meningitis. Eur J Neurol 2003, 10(3):271-280.
28. Schacker T., Collier A.C., Hughes J., et al. Clinical and epidemiologic features of primary HIV infection. Ann Intern Med 1996, 125(4):257-264.
29. Adolescents PoAGfAa Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents Available at:, Accessed January 30, 2010. http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf.
30. Gazzard B.G., Anderson J., Babiker A., et al. British HIV Association guidelines for the treatment of HIV-1-infected adults with antiretroviral therapy 2008. HIV Med 2008, 9(8):563-608.
31. Breton G., Duval X., Gervais A., et al. Retroviral rebound syndrome with meningoencephalitis after cessation of antiretroviral therapy. Am J Med 2003, 114(9):769-770.
32. Bidstrup C., Andersen P.H., Skinhoj P., et al. Tuberculous meningitis in a country with a low incidence of tuberculosis: still a serious disease and a diagnostic challenge. Scand J Infect Dis 2002, 34(11):811-814.
33. Davis L.E., Rastogi K.R., Lambert L.C., et al. Tuberculous meningitis in the southwest United States: a community-based study. Neurology 1993, 43(9):1775-1778.
34. Klein N.C., Damsker B., Hirschman S.Z. Mycobacterial meningitis. Retrospective analysis from 1970 to 1983. Am J Med 1985, 79(1):29-34.
35. Ogawa S.K., Smith M.A., Brennessel D.J., et al. Tuberculous meningitis in an urban medical center. Medicine (Baltimore) 1987, 66(4):317-326.
36. Phypers M., Harris T., Power C. CNS tuberculosis: a longitudinal analysis of epidemiological and clinical features. Int J Tuberc Lung Dis 2006, 10(1):99-103.
37. Rock R.B., Olin M., Baker C.A., et al. Central nervous system tuberculosis: pathogenesis and clinical aspects. Clin Microbiol Rev 2008, 21(2):243-261.
38. Verdon R., Chevret S., Laissy J.P., et al. Tuberculous meningitis in adults: review of 48 cases. Clin Infect Dis 1996, 22(6):982-988.
39. Vinnard C., Macgregor R.R. Tuberculous meningitis in HIV-infected individuals. Curr HIV/AIDS Rep 2009, 6(3):139-145.
40. Kent S.J., Crowe S.M., Yung A., et al. Tuberculous meningitis: a 30-year review. Clin Infect Dis 1993, 17(6):987-994.
41. Zuger A. Tuberculosis. Infections of the central nervous system 2004, 441-459. Lippincott, Williams, and Wilkins, Philadelphia. 3rd edition. W.M. Scheld, R.J. Whitley, C.M. Marra (Eds.).
42. Sutlas P.N., Unal A., Forta H., et al. Tuberculous meningitis in adults: review of 61 cases. Infection 2003, 31(6):387-391.
43. Girgis N.I., Sultan Y., Farid Z., et al. Tuberculosis meningitis, Abbassia Fever Hospital-Naval Medical Research Unit No. 3-Cairo, Egypt, from 1976 to 1996. Am J Trop Med Hyg 1998, 58(1):28-34.
44. Thwaites G., Fisher M., Hemingway C., et al. British Infection Society guidelines for the diagnosis and treatment of tuberculosis of the central nervous system in adults and children. J Infect 2009, 59(3):167-187.
45. Thwaites G.E., Tran T.H. Tuberculous meningitis: many questions, too few answers. Lancet Neurol 2005, 4(3):160-170.
46. Berenguer J., Moreno S., Laguna F., et al. Tuberculous meningitis in patients infected with the human immunodeficiency virus. N Engl J Med 1992, 326(10):668-672.
47. Cecchini D., Ambrosioni J., Brezzo C., et al. Tuberculous meningitis in HIV-infected and non-infected patients: comparison of cerebrospinal fluid findings. Int J Tuberc Lung Dis 2009, 13(2):269-271.
48. Thwaites G.E., Duc Bang N., Huy Dung N., et al. The influence of HIV infection on clinical presentation, response to treatment, and outcome in adults with tuberculous meningitis. J Infect Dis 2005, 192(12):2134-2141.
49. Whiteman M., Espinoza L., Post M.J., et al. Central nervous system tuberculosis in HIV-infected patients: clinical and radiographic findings. AJNR Am J Neuroradiol 1995, 16(6):1319-1327.
50. Dube M.P., Holtom P.D., Larsen R.A. Tuberculous meningitis in patients with and without human immunodeficiency virus infection. Am J Med 1992, 93(5):520-524.
51. Mazurek G.H., Jereb J., Lobue P., et al. Guidelines for using the QuantiFERON-TB Gold test for detecting Mycobacterium tuberculosis infection, United States. MMWR Recomm Rep 2005, 54(RR-15):49-55.
52. Mazurek G.H., Weis S.E., Moonan P.K., et al. Prospective comparison of the tuberculin skin test and 2 whole-blood interferon-gamma release assays in persons with suspected tuberculosis. Clin Infect Dis 2007, 45(7):837-845.
53. Pai M., Riley L.W., Colford J.M. Interferon-gamma assays in the immunodiagnosis of tuberculosis: a systematic review. Lancet Infect Dis 2004, 4(12):761-776.
54. Bernaerts A., Vanhoenacker F.M., Parizel P.M., et al. Tuberculosis of the central nervous system: overview of neuroradiological findings. Eur Radiol 2003, 13(8):1876-1890.
55. Kumar R., Kohli N., Thavnani H., et al. Value of CT scan in the diagnosis of meningitis. Indian Pediatr 1996, 33(6):465-468.
56. Morgado C., Ruivo N. Imaging meningo-encephalic tuberculosis. Eur J Radiol 2005, 55(2):188-192.
57. Nair P.P., Kalita J., Kumar S., et al. MRI pattern of infarcts in basal ganglia region in patients with tuberculous meningitis. Neuroradiology 2009, 51(4):221-225.
58. Thwaites G.E., Macmullen-Price J., Tran T.H., et al. Serial MRI to determine the effect of dexamethasone on the cerebral pathology of tuberculous meningitis: an observational study. Lancet Neurol 2007, 6(3):230-236.
59. Jeren T., Beus I. Characteristics of cerebrospinal fluid in tuberculous meningitis. Acta Cytol 1982, 26(5):678-680.
60. Thwaites G.E., Chau T.T., Stepniewska K., et al. Diagnosis of adult tuberculous meningitis by use of clinical and laboratory features. Lancet 2002, 360(9342):1287-1292.
61. Thwaites G.E., Chau T.T., Farrar J.J. Improving the bacteriological diagnosis of tuberculous meningitis. J Clin Microbiol 2004, 42(1):378-379.
62. Pai M., Flores L.L., Pai N., et al. Diagnostic accuracy of nucleic acid amplification tests for tuberculous meningitis: a systematic review and meta-analysis. Lancet Infect Dis 2003, 3(10):633-643.
63. Thwaites G.E., Caws M., Chau T.T., et al. Comparison of conventional bacteriology with nucleic acid amplification (amplified mycobacterium direct test) for diagnosis of tuberculous meningitis before and after inception of antituberculosis chemotherapy. J Clin Microbiol 2004, 42(3):996-1002.
64. Updated guidelines for the use of nucleic acid amplification tests in the diagnosis of tuberculosis. MMWR Morb Mortal Wkly Rep 2009, 58(1):7-10.
65. Treatment of tuberculosis. MMWR Recomm Rep 2003, 52(RR-11):1-77.
66. The National Collaborating Centre for Chronic Conditions Tuberculosis: clinical diagnosis and management of tuberculosis, and measures for its prevention and control 2006, Royal College of Physicians, London.
67. Prasad K., Singh M.B. Corticosteroids for managing tuberculous meningitis. Cochrane Database Syst Rev 2008, 1. CD002244.
68. Schoeman J., Donald P., van Zyl L., et al. Tuberculous hydrocephalus: comparison of different treatments with regard to ICP, ventricular size and clinical outcome. Dev Med Child Neurol 1991, 33(5):396-405.
69. Mathew J.M., Rajshekhar V., Chandy M.J. Shunt surgery in poor grade patients with tuberculous meningitis and hydrocephalus: effects of response to external ventricular drainage and other variables on long term outcome. J Neurol Neurosurg Psychiatry 1998, 65(1):115-118.
70. Rees J.R., Pinner R.W., Hajjeh R.A., et al. The epidemiological features of invasive mycotic infections in the San Francisco Bay area, 1992-1993: results of population-based laboratory active surveillance. Clin Infect Dis 1998, 27(5):1138-1147.
71. Pachner A.R., Steere A.C. The triad of neurologic manifestations of Lyme disease: meningitis, cranial neuritis, and radiculoneuritis. Neurology 1985, 35(1):47-53.
72. Clark J.R., Carlson R.D., Sasaki C.T., et al. Facial paralysis in Lyme disease. Laryngoscope 1985, 95(11):1341-1345.
73. Recommendations for test performance and interpretation from the Second National Conference on Serologic Diagnosis of Lyme Disease. MMWR Morb Mortal Wkly Rep 1995, 44(31):590-591.
74. Blanc F., Jaulhac B., Fleury M., et al. Relevance of the antibody index to diagnose Lyme neuroborreliosis among seropositive patients. Neurology 2007, 69(10):953-958.
75. Wormser G.P., Dattwyler R.J., Shapiro E.D., et al. The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 2006, 43(9):1089-1134.
76. Halperin J.J., Shapiro E.D., Logigian E., et al. Practice parameter: treatment of nervous system Lyme disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2007, 69(1):91-102.
77. Lee J.W., Wilck M., Venna N. Dementia due to neurosyphilis with persistently negative CSF VDRL. Neurology 2005, 65(11):1838.
78. Flood J.M., Weinstock H.S., Guroy M.E., et al. Neurosyphilis during the AIDS epidemic, San Francisco, 1985-1992. J Infect Dis 1998, 177(4):931-940.
79. Marra C.M., Maxwell C.L., Smith S.L., et al. Cerebrospinal fluid abnormalities in patients with syphilis: association with clinical and laboratory features. J Infect Dis 2004, 189(3):369-376.
80. Ghanem K.G., Moore R.D., Rompalo A.M., et al. Neurosyphilis in a clinical cohort of HIV-1-infected patients. AIDS 2008, 22(10):1145-1151.
81. Castro R., Prieto E.S., da Luz Martins Pereira F. Nontreponemal tests in the diagnosis of neurosyphilis: an evaluation of the Venereal Disease Research Laboratory (VDRL) and the Rapid Plasma Reagin (RPR) tests. J Clin Lab Anal 2008, 22(4):257-261.
82. Davis L.E., Schmitt J.W. Clinical significance of cerebrospinal fluid tests for neurosyphilis. Ann Neurol 1989, 25(1):50-55.
83. Smikle M.F., James O.B., Prabhakar P. Diagnosis of neurosyphilis: a critical assessment of current methods. South Med J 1988, 81(4):452-454.
84. Jaffe H.W., Larsen S.A., Peters M., et al. Tests for treponemal antibody in CSF. Arch Intern Med 1978, 138(2):252-255.
85. MacLean S., Luger A. Finding neurosyphilis without the Venereal Disease Research Laboratory test. Sex Transm Dis 1996, 23(5):392-394.
86. Marra C.M., Critchlow C.W., Hook E.W., et al. Cerebrospinal fluid treponemal antibodies in untreated early syphilis. Arch Neurol 1995, 52(1):68-72.
87. Delaney P. Neurologic manifestations in sarcoidosis: review of the literature, with a report of 23 cases. Ann Intern Med 1977, 87(3):336-345.
88. Ferriby D., de Seze J., Stojkovic T., et al. Long-term follow-up of neurosarcoidosis. Neurology 2001, 57(5):927-929.
89. Stern B.J., Krumholz A., Johns C., et al. Sarcoidosis and its neurological manifestations. Arch Neurol 1985, 42(9):909-917.
90. Zajicek J.P., Scolding N.J., Foster O., et al. Central nervous system sarcoidosis-diagnosis and management. QJM 1999, 92(2):103-117.
91. Nowak D.A., Widenka D.C. Neurosarcoidosis: a review of its intracranial manifestation. J Neurol 2001, 248(5):363-372.
92. Joseph F.G., Scolding N.J. Sarcoidosis of the nervous system. Pract Neurol 2007, 7(4):234-244.
93. Mana J. Magnetic resonance imaging and nuclear imaging in sarcoidosis. Curr Opin Pulm Med 2002, 8(5):457-463.
94. Miller D.H., Kendall B.E., Barter S., et al. Magnetic resonance imaging in central nervous system sarcoidosis. Neurology 1988, 38(3):378-383.
95. Pickuth D., Heywang-Kobrunner S.H. Neurosarcoidosis: evaluation with MRI. J Neuroradiol 2000, 27(3):185-188.
96. Dubey N., Miletich R.S., Wasay M., et al. Role of fluorodeoxyglucose positron emission tomography in the diagnosis of neurosarcoidosis. J Neurol Sci 2002, 205(1):77-81.
97. Sharma O.P. Neurosarcoidosis: a personal perspective based on the study of 37 patients. Chest 1997, 112(1):220-228.
98. Balm M., Hammack J. Leptomeningeal carcinomatosis. Presenting features and prognostic factors. Arch Neurol 1996, 53(7):626-632.
99. van Oostenbrugge R.J., Twijnstra A. Presenting features and value of diagnostic procedures in leptomeningeal metastases. Neurology 1999, 53(2):382-385.
100. Wasserstrom W.R., Glass J.P., Posner J.B. Diagnosis and treatment of leptomeningeal metastases from solid tumors: experience with 90 patients. Cancer 1982, 49(4):759-772.
101. Kaplan J.G., DeSouza T.G., Farkash A., et al. Leptomeningeal metastases: comparison of clinical features and laboratory data of solid tumors, lymphomas and leukemias. J Neurooncol 1990, 9(3):225-229.
102. Straathof C.S., de Bruin H.G., Dippel D.W., et al. The diagnostic accuracy of magnetic resonance imaging and cerebrospinal fluid cytology in leptomeningeal metastasis. J Neurol 1999, 246(9):810-814.
103. Freilich R.J., Krol G., DeAngelis L.M. Neuroimaging and cerebrospinal fluid cytology in the diagnosis of leptomeningeal metastasis. Ann Neurol 1995, 38(1):51-57.
104. Glantz M.J., Cole B.F., Glantz L.K., et al. Cerebrospinal fluid cytology in patients with cancer: minimizing false-negative results. Cancer 1998, 82(4):733-739.
105. Hegde U., Filie A., Little R.F., et al. High incidence of occult leptomeningeal disease detected by flow cytometry in newly diagnosed aggressive B-cell lymphomas at risk for central nervous system involvement: the role of flow cytometry versus cytology. Blood 2005, 105(2):496-502.
106. Gleissner B., Chamberlain M.C. Neoplastic meningitis. Lancet Neurol 2006, 5(5):443-452.
107. Chan T.Y., Parwani A.V., Levi A.W., et al. Mollaret's meningitis: cytopathologic analysis of fourteen cases. Diagn Cytopathol 2003, 28(5):227-231.
108. Kupila L., Vainionpaa R., Vuorinen T., et al. Recurrent lymphocytic meningitis: the role of herpesviruses. Arch Neurol 2004, 61(10):1553-1557.
109. Picard F.J., Dekaban G.A., Silva J., et al. Mollaret's meningitis associated with herpes simplex type 2 infection. Neurology 1993, 43(9):1722-1727.
110. Shalabi M., Whitley R.J. Recurrent benign lymphocytic meningitis. Clin Infect Dis 2006, 43(9):1194-1197.
111. Bergstrom T., Alestig K. Treatment of primary and recurrent herpes simplex virus type 2 induced meningitis with acyclovir. Scand J Infect Dis 1990, 22(2):239-240.
112. Sato R., Ayabe M., Shoji H., et al. Herpes simplex virus type 2 recurrent meningitis (Mollaret's meningitis): a consideration for the recurrent pathogenesis. J Infect 2005, 51(4):e217-e220.
113. Ginsberg L., Kidd D. Chronic and recurrent meningitis. Pract Neurol 2008, 8(6):348-361.
114. Krueger D.W., Larson E.B. Recurrent fever of unknown origin, coma, and meningismus due to a leaking craniopharyngioma. Am J Med 1988, 84(3 Pt 1):543-545.
115. Lunardi P., Missori P. Cranial and spinal tumors with meningitic onset. Ital J Neurol Sci 1990, 11(2):145-151.
116. Schwartz J.F., Balentine J.D. Recurrent meningitis due to an intracranial epidermoid. Neurology 1978, 28(2):124-129.
117. Crossley G.H., Dismukes W.E. Central nervous system epidermoid cyst: a probable etiology of Mollaret's meningitis. Am J Med 1990, 89(6):805-806.
118. de Chadarevian J.P., Becker W.J. Mollaret's recurrent aseptic meningitis: relationship to epidermoid cysts. Light microscopic and ultrastructural cytological studies of the cerebrospinal fluid. J Neuropathol Exp Neurol 1980, 39(6):661-669.
119. Calabro F., Capellini C., Jinkins J.R. Rupture of spinal dermoid tumors with spread of fatty droplets in the cerebrospinal fluid pathways. Neuroradiology 2000, 42(8):572-579.
120. Moris G., Garcia-Monco J.C. The challenge of drug-induced aseptic meningitis. Arch Intern Med 1999, 159(11):1185-1194.