Cerebral haemodynamics in acute bacterial meningitis in adults.
BACKGROUND
Vascular complications are an important cause of neurological sequelae among adult survivors of acute bacterial meningitis (ABM).


OBJECTIVE
To examine the haemodynamic changes associated with ABM.


METHODS
Serial transcranial colour-coded sonography (TCCS) and magnetic resonance angiography (MRA) were used to examine cerebrovascular changes in adult ABM patients. Outcome at 3 months was categorized using a modified Barthel index.


RESULTS
We recruited 24 patients, 12 men and 12 women, aged 21-68 years. Mean cerebral blood flow velocity (V(mean)) increased from day 1 to day 4 in the middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA). On day 4, V(mean) values in the MCA, ACA and PCA were all significantly higher than reference values in healthy volunteers. At 3 months follow-up, 16 cases had good outcomes, while the other eight had poor outcomes. Under multiple logistic regression analysis, only Glasgow coma score (GCS) at admission was independently associated with the three-month outcome.


CONCLUSIONS
In these patient, stenosis as demonstrated by TCCS did not wholly coincide with stenosis as demonstrated by MRA, and the presence of intracranial stenosis was not predictive of a poor outcome at 3 months. Further studies are needed to delineate the characteristics and significance of cerebrovascular changes in adult ABM.
Lu
C-H
CH
Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan. chlu99@ms44.url.com.tw
Chang
H-W
HW
Lui
C-C
CC
Huang
C-R
CR
Chang
W-N
WN
D000208:Acute Disease; D000328:Adult; D000368:Aged; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000503:physiopathology*; D008875:Middle Aged; D012720:Severity of Illness Index