CT parenchymal abnormalities in bacterial meningitis: clinical significance

Over a 5 year period, 80 children with acute bacterial meningitis underwent computed tomography (CT) because of neurologic complications. In nine children, CT disclosed parenchymal abnormalities. The type of parenchymal abnormality was classified as mild, moderate, or severe on the basis of the severity and location of brain injury. All children had neurologic deficits at the time they underwent CT. The seven surviving children were followed for a mean of 32 months. The four children with either mild or moderate CT changes recovered without neurologic sequelae. The five children with severe CT abnormalities either died (two) or survived with major neurologic (two mentally retarded; three major motor deficits) sequelae. Computed tomography is of prognostic value in children with bacterial meningitis.