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Stroke patterns in neonatal group B streptococcal meningitis

Marta I Hernández1, Carmen C Sandoval, Jose L Tapia

  • 1Department of Pediatrics, Pontificia Universidad Católica de Chile, Santiago, Chile.

Pediatric Neurology
|March 15, 2011
PubMed

Insights

Neonatal group B streptococcus meningitis can cause brain damage. This study identified specific imaging patterns of stroke in affected newborns, highlighting a potentially treatable cause of poor neurologic outcomes.

Area of Science:

  • Neonatal Neurology
  • Pediatric Infectious Diseases
  • Neuroimaging

Background:

  • Neonatal group B streptococcus meningitis is a significant cause of infant morbidity and mortality.
  • Cerebrovascular complications are common but poorly understood in this condition.
  • Identifying imaging patterns of stroke may reveal modifiable pathophysiologic processes.

Purpose of the Study:

  • To investigate and characterize imaging patterns of focal brain infarction in term neonates diagnosed with group B streptococcus meningitis.
  • To correlate these imaging findings with clinical presentation and neurologic outcomes.

Main Methods:

  • A consecutive case series of term neonates with bacterial meningitis and confirmed group B streptococcus infection.
  • Brain magnetic resonance imaging (MRI) was performed within 14 days of diagnosis.
  • Focal intraparenchymal infarctions with restricted diffusion were identified and classified by location (deep perforator vs. superficial cortical).

Main Results:

  • Eight neonates (50% female) with focal infarction were identified.
  • Two main stroke patterns were observed: deep perforator arterial stroke (88%) and superficial cortical injury (75%).
  • Poor neurologic outcomes, including severe disability or death, occurred in 75% of cases.

Conclusions:

  • Recognizable patterns of focal brain infarction are associated with neonatal group B streptococcus meningitis.
  • These stroke patterns contribute to severe neurologic morbidity and mortality.
  • Understanding these cerebrovascular changes may lead to targeted, modifiable therapeutic strategies.

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