Rhombencephalitis in cocaine-induced nasal septal perforation and skull base erosion

Authors

Shuo Li, Department of Interventional Radiology, University of Miami/Jackson Memorial HospitalMiamiFlorida.Follow
Gunjan Garg, Department of Radiology, Yale New Haven Health Bridgeport HospitalBridgeportConnecticut.
Bobby Goyal, Department of Physiology and Neuroscience, St. George's University School of MedicineGreat RiverNew York.Follow
Ahmed Abdelbaki, Department of Radiology, Yale New Haven Health Bridgeport HospitalBridgeportConnecticut.Follow
Rahul Hegde, Department of Radiology, Yale New Haven Health Bridgeport HospitalBridgeportConnecticut.Follow
Anil Kumar, Department of Neurology, Great Plains HealthNorth PlatteNebraska.Follow
Mark Rosovsky, Department of Radiology, Yale New Haven Health Bridgeport HospitalBridgeportConnecticut.Follow

Document Type

Article

Publication Title

Proceedings (Baylor University. Medical Center)

Abstract

Rhombencephalitis is a rare and potentially fatal condition involving the brainstem, with infectious, autoimmune, and paraneoplastic etiologies. We present a patient presenting with left-extremity weakness and dysphonia who had brainstem imaging findings suggestive of rhombencephalitis. We suspect that the case was due to inoculation of the brainstem from nasopharyngeal adenoviral infection. Due to heavy cocaine use, extensive basiocciput erosion led to direct contact between the brainstem and the nasopharyngeal mucosa. The patient's milder clinical course might have been due to some degree of pre-existing immunity against adenovirus. Additionally, clinicians need to be aware of the proximity of the brainstem to the nasopharynx when there is basiocciput erosion, due to the potential risk of injury during instrumentation.

First Page

82

Last Page

84

DOI

10.1080/08998280.2018.1536586

Publication Date

1-1-2019

Recommended Citation

Li, Shuo; Garg, Gunjan; Goyal, Bobby; Abdelbaki, Ahmed; Hegde, Rahul; Kumar, Anil; and Rosovsky, Mark, "Rhombencephalitis in cocaine-induced nasal septal perforation and skull base erosion" (2019). Radiology. 81.
https://scholar.bridgeporthospital.org/radiology/81

Identifier

30956592 (pubmed); PMC6442913 (pmc); 10.1080/08998280.2018.1536586 (doi); 1536586 (pii)