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Arterial cerebrovascular complications in 94 adults with acute bacterial meningitis

Matthias Klein1, Uwe Koedel, Thomas Pfefferkorn

  • 1Department of Neurology, Klinikum Grosshadern, Ludwig Maximilians University, Marchioninistr, 15, D-81377 Munich, Germany. matthias.klein@med.uni-muenchen.de

Critical Care (London, England)
|November 25, 2011
PubMed

Insights

Transracranial Doppler (TCD) effectively identifies elevated cerebral blood flow velocity in bacterial meningitis patients. This elevation significantly increases the risk of stroke and poor outcomes.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Acute bacterial meningitis can lead to serious intracranial vascular complications, including ischemic stroke.
  • Stroke in meningitis is often attributed to vasculitis, vasospasm, endocarditis, or thrombosis.
  • Identifying patients at risk for stroke is crucial for timely intervention.

Purpose of the Study:

  • To evaluate the utility of measuring cerebral blood flow velocity (CBFv) using transracranial Doppler (TCD) for identifying patients at risk of meningitis-associated stroke.
  • To assess the correlation between elevated CBFv and the incidence of stroke in patients with acute bacterial meningitis.

Main Methods:

  • A retrospective analysis of 114 patients with acute bacterial meningitis treated between 2000 and 2009.
  • Routine transracranial Doppler (TCD) studies were performed on 94 patients.
  • Data focused on the incidence of elevated CBFv (peak systolic values > 150 cm/s) and subsequent stroke development.

Main Results:

  • 41 out of 94 patients (43.6%) exhibited elevated CBFv.
  • Elevated CBFv was significantly associated with an increased risk of stroke (OR = 9.15) and unfavorable outcomes (OR = 2.93).
  • Nimodipine administration did not significantly alter stroke incidence in patients with elevated CBFv.

Conclusions:

  • Transracranial Doppler (TCD) is a valuable bedside tool for detecting arterial abnormalities in bacterial meningitis.
  • Elevated cerebral blood flow velocity detected by TCD indicates a heightened risk of stroke in these patients.
Abstract

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