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July 28, 1969

Isotope Demonstration of CSF PathwaysGuide to Antifungal Therapy in Coccidioidal Meningitis

Author Affiliations

From the National Institute of Neurological Diseases and Stroke and the Diagnostic Radioisotope Section, National Institutes of Health, Bethesda, Md. Dr. McCullough is now with Georgetown University, Washington, DC.

JAMA. 1969;209(4):558-560. doi:10.1001/jama.1969.03160170054018

Obstruction of the outlets of the fourth ventricle and high spinal subarachnoid block developed in a patient with Coccidioides immitis meningitis. Radioisotope visualization procedures demonstrated absence of communication between basal meningeal areas, cerebral ventricles, and spinal theca. Drugs instilled in the crebrospinal fluid could not be effectively delivered to the basal meninges because of the two blocks. Isotope ventriculography and cisternography may be particularly useful in evaluating routes of drug administration in chronic fungal meningitis.