title: Abnormalities of cerebral blood flow in the acute phase of bacterial meningitis in adults.
abstract: The frequency, course and clinical significance of changes in regional cerebral blood flow (rCBF) during bacterial meningitis were investigated in 14 adult patients. The results of 99mTc-hexamethylpropylene amine oxime (HMPAO) single photon emission computed tomography (SPECT) were compared with the clinical signs and findings using cerebral angiography and conventional CT. HMPAO SPECT was performed 2-15 days (median 4.5 days) after the onset of neurological disease. Decreased HMPAO accumulation was detected in 13 patients. SPECT studies revealed focal hypoperfusion corresponding to the clinical symptoms in 6 patients suffering from hemiparesis or hemiataxia. Conventional cranial CT disclosed brain infarction in only 1 patient. Focal hypoperfusion was also found in 7 of 8 patients without clinical evidence of focal neurological deficits. In 6 patients, HMPAO SPECT findings were abnormal although cerebral angiography was normal. At follow-up examinations 3-45 weeks after the acute disease, abnormalities revealed by HMPAO SPECT had improved or had even disappeared in all patients studied. Our results indicate that reduced rCBF is a frequent finding in bacterial meningitis in the adult. In most patients it probably represents a functional and reversible disorder without structural lesion detectable on CT.
authors.affiliation: Neurologische Klinik, Ludwig-Maximilians-Universität, München, Federal Republic of Germany.
authors.forename: S
authors.initials: S
authors.lastname: Förderreuther
authors.forename: K
authors.initials: K
authors.lastname: Tatsch
authors.forename: K M
authors.initials: KM
authors.lastname: Einhäupl
authors.forename: H W
authors.initials: HW
authors.lastname: Pfister
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008875:Middle Aged; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed