[Ischemic changes and blood coagulation abnormalities as complications of pneumococcal meningitis].
One explanation for cerebral infarctions that occur as a complication of pneumococcal meningitis is blood coagulation abnormalities. We investigated the clinical features, laboratory test results, magnetic resonance imaging (MRI) findings, and pathological features of 10 patients with pneumococcal meningitis between 2006 and 2013 to examine the abnormal findings that may be associated with prognosis. Five patients (50%) that had Glasgow Outcome Scale scores between 1 and 4 were classified as the poor outcome group. In this group, the MRI revealed a high signal intensity on the diffusion-weighted image (DWI), and there was an abnormal signal along the cerebral cortex and Virchow-Robin spaces, which were characterized pathologically by ischemic changes. The plasma thrombin-antithrombin complex (TAT) levels showed greater differences between the poor and good prognosis groups than platlet and D-dimer levels; this suggested that high plasma TAT levels indicate a poor prognosis.
Department of Neurology, Seirei Hamamatsu General Hospital.
Takashi
T
Sugiyama
Tsuyoshi
T
Uchiyama
Hirotsugu
H
Takashima
Daisuke
D
Yamamoto
Keishiro
K
Sato
Takako
T
Shimizu
Yoshiro
Y
Otsuki
Toshihiko
T
Ohashi
D000328:Adult; D000368:Aged; D000990:Antithrombin III; D015415:Biomarkers / Q000097:blood; D001778:Blood Coagulation Disorders / Q000209:etiology*; D002540:Cerebral Cortex / Q000473:pathology; D002544:Cerebral Infarction / Q000209:etiology* / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products; D023261:Glasgow Outcome Scale; D006801:Humans; D008297:Male; D008586:Meningitis, Pneumococcal / Q000150:complications* / Q000473:pathology; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000097:blood; D010976:Platelet Count; D011379:Prognosis
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; D000990:Antithrombin III; D010447:Peptide Hydrolases