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Serial transcranial Doppler study in meningitis

R Gupta1, A K Mahapatra, R Bhatia

  • 1Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences (AIIMS), New Delhi.

Acta Neurochirurgica
|January 1, 1995
PubMed
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Transcranial Doppler studies reveal that elevated blood flow velocities in basal cerebral vessels correlate with increased cerebrospinal fluid (CSF) white blood cell (WBC) counts and decreased CSF sugar levels during meningitis.

Area of Science:

  • Neurology
  • Neurocritical Care
  • Cerebrovascular Physiology

Background:

  • Meningitis, an inflammation of the membranes surrounding the brain and spinal cord, can lead to significant neurological complications.
  • Cerebrospinal fluid (CSF) analysis is crucial for diagnosing meningitis, assessing its severity, and monitoring treatment response.
  • Transcranial Doppler (TCD) ultrasound is a non-invasive tool used to evaluate cerebral blood flow dynamics.

Purpose of the Study:

  • To investigate the relationship between blood flow velocities in the large basal cerebral vessels and key cerebrospinal fluid (CSF) parameters in patients with hospital-acquired meningitis.
  • To determine if TCD can serve as a useful indicator of meningitis severity and progression.

Main Methods:

  • Serial transcranial Doppler (TCD) examinations were performed on 12 patients diagnosed with meningitis during their hospital stay.

Related Experiment Videos

  • Blood flow velocities in the anterior circle of Willis were measured and correlated with CSF white blood cell (WBC) counts and CSF glucose (sugar) levels.

    • Main Results:

    • Mean blood flow velocities demonstrated a direct proportionality to CSF WBC count, indicating higher velocities with increased inflammation.
    • Blood flow velocities showed an inverse relationship with CSF sugar values, decreasing as glucose levels rose.
    • Significantly elevated blood flow velocities were observed during active meningitis, often coinciding with reduced CSF sugar levels.

    Conclusions:

    • Transcranial Doppler (TCD) can reflect the inflammatory state and metabolic changes associated with meningitis.
    • Cerebral blood flow velocity, as measured by TCD, appears to be a sensitive marker for meningitis, correlating with CSF pleocytosis and reduced glucose levels.