title: Temporal alterations in brain water diffusivity in neonatal meningitis.
abstract: OBJECTIVE
  To compare changes in apparent diffusion coefficient (ADC) in neonatal meningitis using serial diffusion-weighted imaging (DWI).
  
  
  METHODS
  Thirty neonates with meningitis and 12 age/sex-matched controls were studied using DWI. ADC was quantified by placing region of interest(s) on periventricular white matter during acute illness and again at 21 days. Three groups of patients were studied: those with normal findings on both conventional MRI and DWI, those with abnormal DWI only and those with abnormal conventional MRI as well as DWI. Neurodevelopment assessment was performed in controls and patients at 3 months using Indian adaptation of Bayley scales of infant development (BSID) kit.
  
  
  RESULTS
  Patients with neonatal meningitis with normal imaging (n = 8) showed no significant difference in ADC compared to controls. Patients showing abnormality only on DWI (n = 10) and on both conventional magnetic resonance imaging (MRI) as well as DWI (n = 12) had significantly reduced ADC (p = 0.001) than controls at baseline study. Follow-up study showed no significant differences in ADC in controls compared to any patient group. Significantly reduced neurodevelopmental scores were observed in patient groups compared to controls.
  
  
  CONCLUSIONS
  We conclude that quantitative ADC may detect meningitis-induced hypoxia early in brain parenchyma, which may be associated with abnormal motor and mental development.
authors.affiliation: Department of Pediatrics, Chhatrapati Shahuji Maharaj Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Gyanendra K
authors.initials: GK
authors.lastname: Malik
authors.forename: Abhishek
authors.initials: A
authors.lastname: Yadav
authors.forename: Richa
authors.initials: R
authors.lastname: Trivedi
authors.forename: Arti
authors.initials: A
authors.lastname: Srivastava
authors.forename: Kashi N
authors.initials: KN
authors.lastname: Prasad
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Gupta
mesh_terms: D000704:Analysis of Variance; D001834:Body Water; D001921:Brain / Q000378:metabolism / Q000473:pathology*; D016022:Case-Control Studies; D002555:Cerebrospinal Fluid / Q000737:chemistry; D002954:Citrobacter / Q000302:isolation & purification; D002658:Developmental Disabilities / Q000209:etiology; D004058:Diffusion; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis* / Q000209:etiology; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications* / Q000382:microbiology; D009420:Nervous System / Q000254:growth & development / Q000473:pathology; D013291:Streptococcus / Q000302:isolation & purification