Year: 2011
Type: article
Study design: Case Report
Abstract: Rhomboencephalitis due to cocaine-induced bony erosion of skull baseA 49-year-old man with 10 years of intranasal cocaine use presented with dysphagia.Neurologic examination demonstrated bilateral sixth nerve palsies.Brain MRI showed erosion of the sphenoid sinus walls and a defect in the skull base; the resulting path between the nasal cavity and brainstem permitted rhomboencephalitis and clival osteomyelitis (figure 1).Clival cultures grew methicillin-resistant Staphylococcus aureus.IV antibiotics were administered and switched to oral after 6 weeks.Repeat MRI showed decreased T2 fluid-attenuated inversion recovery brainstem hyperintensity (figure 2).Antibiotics will be used for at least 1 year; surgical reconstruction of the skull base will depend on his abstinence from cocaine.
Source: Neurology
Authors: Jordan S. Dubow, Samuel Singer, Alan Z. Segal
Institution: Weill Cornell Medicine
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2037730723