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AXONAL VARIANT OF GUILLAIN-BARRÉ SYNDROME ASSOCIATED WITH CAMPYLOBACTER INFECTION IN BANGLADESH

patients (cases 1 and 6). In case 1, magnetic resonance angiography was performed on day 12 and showed segmental narrowing of the basilar artery, which was initially attributed to vasculitis. In the sixth case, magnetic resonance angiography was performed on day 19, 1 day after neurologic deterioration, and showed normal intracranial vessels. Vasculitis and vasospasm have often been implicated in stroke in bacterial meningitis.4 However, postmortem examination of the basilar artery in our first case did not show any evidence of vasculitis. This illustrates the difficulty in applying the concepts of vasculitis and vasospasm to determine the cause of stroke when relying solely on vascular imaging studies in the absence of postmortem pathologic corroboration. Similar difficulties have been reported with the concept of vasospasm in determining the cause of stroke in another important disease affecting the meninges: subarachnoid hemorrhage.5 We hope that our findings will prompt other authors of previous large series of bacterial meningitis to re-review their records in order to find similar cases. This might shed further light on the possible cause of this devastating complication and on its relation to the use of adjuvant dexamethasone therapy.