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Published on: November 5, 2019
[Cerebral infarction associated with meningitis]
Y Hashimoto1, K Kimura, T Hirano
1Department of Neurology, Kumamoto City Hospital.
Abstract:
Among 43 adult patients with meningitis, 8 (18.6%) had cerebral infarction associated with meningitis during their clinical course. The total number of cerebral infarctions was 18. In 4 patients of good outcome (ambulatory in 3 cases and wheelchair in 1 case) with a mean age of 39 years, the number of cerebral infarctions was 1 per patient, and did not increase. In 4 patients of poor outcome (vegetative in 2 cases and died in 2 cases) with a mean age of 68 years, the number of cerebral infarctions was 1 in two cases and 2 in two cases, and later increased in 3 of the cases. Locations of cerebral infarctions were 3 in the striatocapsular lesion, 1 in the posterior limb of internal capsule, 1 in the middle cerebral artery territory, 5 in the tuberothalamic artery territory, 5 in the capsular genu, 1 in the posterior choroidal artery territory, and 2 in the medial striate artery territory. Patients of poor outcome had capsular genu infarction. It was concluded that multiplicity and multiplication of cerebral infarction were markers of the severity of the meningitis.
Insights
Cerebral infarction occurred in 18.6% of meningitis patients. Multiple cerebral infarctions, particularly in the capsular genu, indicate meningitis severity and predict poor patient outcomes.
Area of Science:
- Neurology
- Infectious Diseases
Context:
- Meningitis is a serious infection affecting the central nervous system.
- Cerebral infarction is a known complication of meningitis, but its prognostic significance requires further elucidation.
Purpose:
- To investigate the incidence and characteristics of cerebral infarction in adult patients with meningitis.
- To determine the association between cerebral infarction patterns and patient outcomes.
Summary:
- Cerebral infarction was observed in 8 out of 43 (18.6%) adult meningitis patients.
- Patients with poor outcomes (vegetative or deceased) exhibited a higher number and multiplication of cerebral infarctions compared to those with good outcomes.
- Capsular genu infarction was specifically associated with poor outcomes, suggesting it as a marker of meningitis severity.
Impact:
- Identifies multiplicity and multiplication of cerebral infarction as potential markers for assessing meningitis severity.
- Highlights the prognostic value of specific infarction locations, such as the capsular genu, in meningitis patients.
- Informs clinical assessment and management strategies for meningitis by correlating neuroimaging findings with patient prognosis.
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Bacterial Meningitis I: Introduction
Bacterial Meningitis II: Pathophysiology
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