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Rate ePoster

Neurological Rehabilitation

Rehabilitation of Post-Laminectomy Gleimia Europaea Ventriculitis and Hydrocephalus

Friday, October 24, 2025
8:00 AM - 9:15 AM MT
Location: Kiosk 5

    Poster Presenter(s)

  • Ilan C. Palte, MD

    Resident Physician
    McGaw Medical Center of Northwestern University (SRAL) PM&R Program
    Chicago, Illinois

    • Co-Author(s)

  • Jacqueline Dargan, MD

    Resident Physician
    McGaw Medical Center of Northwestern University (SRAL) PM&R Program
    Chicago, Illinois

  • HB

    Hollis Bell, MD

    Attending physician
    Shirley Ryan Ability Lab
    Chicago, Illinois

Disclosure(s):
Ilan C. Palte, MD: No financial relationships to disclose
Jacqueline Dargan, MD: No financial relationships to disclose
Case Diagnosis: This case reviews rehabilitation of a nontraumatic brain injury (NTBI) after elective spinal surgery.

Case Description or Program Description: 59-year-old male, with recent bilateral hip replacement, found to have cervical stenosis with myelopathy. After a cervical laminectomy and fusion, patient developed Gleimia europaea ventriculitis, hydrocephalus, and bilateral cerebellar and frontal subdural empyemas. He underwent a surgical site washout, ventriculo-peritoneal (VP) shunt placement, and was placed on IV antibiotics. He was admitted to an inpatient rehabilitation facility (IRF) fifty-four (54) days after elective acute hospital admission.

Setting: Inpatient Rehabilitation Facility

Assessment/Results: While admitted to IRF, patient’s medical treatment focused on maximizing alertness, cognition, and motor function while monitoring for worsening hydrocephalus or infection. He required maximum assist for ADLs and mobility, and minimal assistance for cognitive function on admission. His IRF course included collaboration with neurosurgery for VP shunt adjustments, infectious disease for trials of different antibiotics to meet anticipated home health infusion requirements, and neurooptometry to address oculomotor impairments. Modafinil, venlafaxine, and trazodone were initiated. Ultimately, the patient was discharged home after 59 days. His discharge functional status was supervision to substantial assist for ADLs, modified-independent to minimal assistance for cognitive function, and he remained dependent for ambulation.

Discussion (relevance): This case illustrates an unusual etiology of NTBI and the necessity of close collaboration with various medical teams to maximize CNS recovery, functional gains, and to minimize ongoing potential comorbidities. While the literature of NTBI rehabilitation encompasses this diagnosis, there is limited literature addressing rehabilitation of infectious NTBI superimposed on cervical myelopathy.

Conclusions: Rehabilitation of concomitant neurologic diagnoses requires not only a coordinated neurologic therapeutic team, but also close attention paid to interdisciplinary subspecialty medical recommendations and medication selection. A collaborative approach can maximize functional gains and decrease caregiver burden on discharge.