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Ultrasound diagnosis of multiple cystic encephalomalacia
R K Gupta1, C S Pant, A Sharma
1Department of Ultrasound, Institute of Nuclear Medicine and Allied Sciences, Delhi, India.
Abstract:
Following bacterial meningitis thirty cases of enlarging head were evaluated on ultrasound to find out the cause. Nine out of 30 patients had multiple cystic lesions in both cerebral hemispheres with or without ventriculomegaly. Three patients showed debris in the cysts suggesting pus, which was confirmed on ultrasound-guided aspiration in two and on surgery in one case. Seven out of nine patients had died at the time of writing this communication, suggesting the need for its early detection and timely family counselling. It is stressed that multiple cystic encephalomalacia has a characteristic appearance on ultrasound and all patients with meningitis should be screened routinely so as to detect it at an early stage.
Insights
Bacterial meningitis can lead to multiple cystic encephalomalacia, a condition with characteristic ultrasound findings. Early detection through routine screening is crucial for timely intervention and family counseling.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Infectious Diseases
Background:
- Bacterial meningitis is a serious infection in children.
- Enlarging head circumference post-meningitis requires etiological investigation.
- Cystic lesions in the brain can be a complication of meningitis.
Purpose of the Study:
- To evaluate the cause of enlarging head circumference in children after bacterial meningitis.
- To identify characteristic ultrasound findings of complications.
- To emphasize the importance of early detection and management.
Main Methods:
- Ultrasound evaluation of 30 cases with enlarging head after bacterial meningitis.
- Identification of cystic lesions and ventriculomegaly.
- Ultrasound-guided aspiration and surgical confirmation of cyst contents.
Main Results:
- Nine out of 30 patients presented with multiple cystic lesions in cerebral hemispheres.
- Three patients had cyst debris suggestive of pus, confirmed by aspiration/surgery.
- Seven of these nine patients died, highlighting the severity of the complication.
Conclusions:
- Multiple cystic encephalomalacia has a distinct ultrasound appearance.
- Routine ultrasound screening for meningitis patients is recommended for early detection.
- Timely diagnosis and family counseling are essential for managing this severe complication.