title: Arterial cerebrovascular complications in 94 adults with acute bacterial meningitis.
abstract: BACKGROUND
  Intracranial vascular complications are an important complication of acute bacterial meningitis. Ischemic stroke in meningitis is reported as a result of vasculitis, vasospasm, endocarditis or intraarterial thrombosis. The aim of the study was to identify the value of measuring cerebral blood flow velocity (CBFv) on transracranial doppler (TCD) in the identification of patients at risk for meningitis-associated stroke.
  
  
  METHODS
  We retrospectively studied patients with acute bacterial meningitis who were treated in our university hospital from 2000 to 2009. Data were analyzed with the main focus on the incidence of an increase of CBFv on TCD, defined as peak systolic values above 150 cm/s, and the development of stroke.
  
  
  RESULTS
  In total, 114 patients with acute bacterial meningitis were treated, 94 of them received routine TCD studies during their hospital stay. 41/94 patients had elevated CBFv values. This increase was associated with an increased risk of stroke (odds ratio (95% confidence intervall) = 9.15 (1.96-42.67); p < 0.001) and unfavorable outcome (Glasgow Outcome Score < 4; odds ratio (95% confidence intervall) = 2.93 (1.23-6.98); p = 0.018). 11/32 (34.4%) patients with an increase of CBFv who received nimodipine and 2/9 (22.2%) patients with an increase of CBFv who did not receive nimodipine developed stroke (p = 0.69).
  
  
  CONCLUSIONS
  In summary, TCD was found to be a valuable bedside test to detect arterial alterations in patients with bacterial meningitis. These patients have an increased risk of stroke.
authors: Department of Neurology, Klinikum Grosshadern, Ludwig Maximilians University, Marchioninistr, 15, D-81377 Munich, Germany. matthias.klein@med.uni-muenchen.de
authors: Matthias
authors: M
authors: Klein
authors: Uwe
authors: U
authors: Koedel
authors: Thomas
authors: T
authors: Pfefferkorn
authors: Grete
authors: G
authors: Zeller
authors: Bianca
authors: B
authors: Woehrl
authors: Hans-Walter
authors: HW
authors: Pfister
mesh_terms: D000328:Adult; D000368:Aged; D002539:Cerebral Arterial Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D002536:Cerebral Arteries / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation / Q000502:physiology; D006801:Humans; D016920:Meningitis, Bacterial / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D017585:Ultrasonography, Doppler, Transcranial