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Stroke in Pediatric Bacterial Meningitis: Population-Based Epidemiology
Mary Dunbar1, Hely Shah2, Siddharth Shinde2
1Department of Community Health Services, University of Calgary, Calgary, Alberta, Canada; Calgary Pediatric Stroke Program, University of Calgary, Calgary, Alberta, Canada.
Pediatric Neurology
|November 6, 2018
Summary
Pediatric bacterial meningitis frequently leads to ischemic stroke, affecting over one-third of patients. This complication significantly increases mortality and neurological deficits, highlighting the need for early detection and intervention.
Area of Science:
- Neurology
- Pediatrics
- Infectious Diseases
Background:
- Bacterial meningitis is a severe central nervous system infection.
- Stroke is a significant complication of bacterial meningitis in children.
- Understanding the incidence and impact of stroke in pediatric meningitis is crucial.
Purpose of the Study:
- To assess the incidence, risk factors, patterns, and outcomes of stroke in pediatric bacterial meningitis.
- To identify demographic and clinical factors associated with stroke in this population.
- To evaluate the impact of stroke on mortality and neurological deficits.
Main Methods:
- Population-based retrospective cohort study (2002-2012) in Southern Alberta, Canada.
- Inclusion criteria: age 0-18 years, laboratory-confirmed acute bacterial meningitis, and brain MRI with diffusion-weighted imaging.
- Outcomes assessed: demographics, clinical presentation, risk factors, laboratory and radiographic findings, and neurological outcomes.
Main Results:
- Out of 43 patients, 16 (37%) had ischemic stroke, often multifocal.
- Stroke patients were more likely to experience seizures, otitis media, and multiple hospital admissions.
- Mortality was higher in patients with stroke (25%) compared to those without (4%).
Conclusions:
- Ischemic stroke is a common complication in children with bacterial meningitis.
- Stroke is associated with increased mortality and long-term neurological deficits.
- Consideration for increased MRI screening and novel treatment strategies is warranted.
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