Bilateral white matter lesions following severe meningococcal meningoencephalitis.

Occasionally, striking abnormalities are found on MRI in patients with mild neurological disturbances. In most of these cases the diagnosis is not immediately evident and the history does not provide an unequivocal explantation. We present a patient with extensive symmetrical white matter abnormalities in the posterior temporal, temporo-occipital and parietal regions, 24 years after documented severe meningococcal meningoencephalitis. A meningitic vasculitis, affecting the insular branches of the middle cerebral arteries, could have been responsible for these changes.