case_images: PMC5480626_01
case_images: CT scan on hospital admission (a) demonstrating herniation of cerebral tissue and (b) on follow-up visit after 6 months subsequent to the cranioplasty of the skull defect.
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case_images: To document the intracranial status on admission, he received a computed tomography (CT) scan (Figure 1(a)). On follow-up 6 months later, he was intermittently awake, was able to respond adequately questions and followed requests, for example, pressed right hand and moved his right leg (CT; Figure 1(b)).
case_images: Cerebral spinal fluid colistin levels measured with HPLC-tandem mass spectroscopy during 37 days of intensive care treatment.
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case_images: TDM (displayed in Figure 2) and renal function (Table 2). ICP via the EVD and subsequently using a lumbar Tuohy catheter (Figure 2). Intrathecal colistin was stopped after a course of altogether 26 days (total amount of 6.5 MIU CMS) and the patient was switched to intravenous colistin monotherapy.
case_images: Cerebral spinal fluid drainage and colistin application during 37 days of intensive care treatment.
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case_images: TDM in ce-rebrospinal fluid (CSF) samples repeatedly reported high concentrations of colistin, local application was reduced to 0.25 MIU via EVD once daily (days 15-16), and paused from day 17 to 20 (Figure 3). The TDM showed decreasing levels of colistin and therapy was continued with 0.25 MIU once daily (days 21-25) resulting in unexpected high levels of colistin.