Related Experiment Videos
Bacterial meningitis as an etiology of perinatal cerebral infarction
L R Ment1, R A Ehrenkranz, C C Duncan
1Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06510.
Abstract:
Despite significant improvement in mortality rate, survivors of neonatal bacterial meningitis experience a significant incidence of neurodevelopmental sequelae. Neuropathologic studies have demonstrated vasculitis, arachnoiditis, and ventriculitis with secondary edema and encephalomalacia. Areas of cerebral infarction, most commonly thought to be venous in origin, have been reported as well. We performed cranial computed tomographic scans on all eight neonates with bacterial meningitis admitted to our Newborn Special Care Unit within the past 36 months and demonstrated abnormalities in seven. Six of these infants were found to have large areas of infarction related primarily to major arterial vascular distributions. We suggest computed tomographic studies for all neonates with bacterial meningitis and subsequent scans at 4-6 months of age in those with abnormal neonatal scans in order to plan better for early intervention services.
Insights
Neonatal bacterial meningitis survivors often face neurodevelopmental issues. Cranial CT scans revealed significant brain infarction in most affected infants, highlighting the need for early detection and intervention.
Area of Science:
- Neurology
- Pediatrics
- Medical Imaging
Background:
- Neonatal bacterial meningitis survivors face significant neurodevelopmental sequelae.
- Neuropathologic findings include vasculitis, arachnoiditis, ventriculitis, edema, and encephalomalacia.
- Cerebral infarction, often attributed to venous causes, is a reported complication.
Purpose of the Study:
- To investigate the incidence and patterns of brain abnormalities in neonates with bacterial meningitis using cranial computed tomographic (CT) scans.
- To identify the vascular origins of cerebral infarction in affected neonates.
Main Methods:
- Cranial CT scans were performed on eight neonates diagnosed with bacterial meningitis.
- Abnormalities were assessed, with a focus on identifying areas of cerebral infarction and their vascular distribution.
Main Results:
- CT scans revealed abnormalities in seven out of eight neonates.
- Six infants presented with large areas of cerebral infarction, predominantly related to major arterial vascular distributions.
- This contrasts with previous assumptions of primarily venous infarction.
Conclusions:
- Cranial CT scans are crucial for diagnosing brain abnormalities in neonatal bacterial meningitis.
- Arterial infarction appears to be a significant complication.
- Recommend CT studies for all neonates with bacterial meningitis and follow-up scans for early intervention planning.