Cranial sonography in bacterial meningitis

Cranial ultrasonography was performed on 61 infants with acute bacterial meningitis (ABM). Thirty nine, infants (64%) had acute meningitis with no clinical evidence of complications (Group-I) and 22 infants (36%) had clinical evidence of complications of ABM (Group-II). Cranial ultrasound was normal in 20 infants (32.8%). The spectrum of sonographic abnormalities included echogenic sulci (60.6%), sulcal separation (49.8%), abnormal parenchymal echoes (42.6%), ventriculomegaly (34.4%), ventriculitis (19.7%), abscess (3.3%), subdural empyema (1.63%) and hemorrhagic infarct (1.63%). Various abnormal findings were seen in all 22 patients of Group II (100%) and in only 19 out of 39 patients in Group I (31.9%). Cranial sonography was comparable to CT scan done in 10 cases of Group II. Our study suggests that ultrasound is a quick, reliable and effective diagnostic tool in diagnosis and management of infants with or without evidence of complications.