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Dementia and capsular genu ischemia in patients with severe bacterial meningitis

Makoto Naito1, Ken Johkura, Takayuki Momoo

  • 1Department of Neurology, Kanagawa Prefectural Ashigara Kami Hospital, Matsuda-cho, Japan.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|October 20, 2009
PubMed

Insights

Severe bacterial meningitis can cause brain damage in the internal capsule genu, leading to dementia. This brain ischemia was not observed in viral meningitis cases, suggesting a link to dementia development.

Area of Science:

  • Neurology
  • Neuroscience
  • Infectious Diseases

Background:

  • Infarction in the internal capsule genu causes dementia, known as capsular genu syndrome, presenting as abulia, lethargy, and memory loss.
  • Post-meningitis dementia is a recognized complication, but its specific pathogenesis remains under investigation.

Purpose of the Study:

  • To investigate the association between capsular genu ischemia and the development of dementia following meningitis.
  • To compare the incidence of capsular genu ischemia in bacterial versus viral meningitis.

Main Methods:

  • Cerebral blood flow and infarction in the internal capsule genu were assessed in patients with severe bacterial and viral meningitis.
  • Clinical outcomes, including the development of dementia, were monitored post-meningitis.

Main Results:

  • Six of 13 patients with severe bacterial meningitis showed infarction or decreased blood flow in the internal capsule genu.
  • Four of these six patients developed post-meningitis dementia with symptoms of abulia, lethargy, and memory loss.
  • None of the 24 patients with viral meningitis exhibited capsular genu ischemia or developed post-meningitis dementia.

Conclusions:

  • Capsular genu ischemia may contribute to the development of dementia in patients with severe bacterial meningitis.
  • The absence of capsular genu ischemia in viral meningitis cases may explain the lower incidence of post-meningitis dementia in these patients.

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