(Stroke. 1995;26:1399-1403.)
© 1995 American Heart Association, Inc.
Articles |
Clinical Relevance and Frequency of Transient Stenoses of the Middle and Anterior Cerebral Arteries in Bacterial Meningitis
From the Department of Neurology, University Hospital of the Saarland, Homburg/Saar, and the Department of Psychiatry, Winnenden (G.P.H.), Germany.
Correspondence to Martin Müller, MD, Department of Neurology, University Hospital of the Saarland, Oscar-Orth-str 3, D-66421 Homburg/Saar, Germany.
Background and Purpose We sought to examine the frequency and clinical relevance of intracranial artery stenoses in patients with bacterial meningitis in whom the occurrence of stroke has angiographically been reported to be associated with stenoses or occlusions of the large basal cerebral arteries.
Methods Thirty-five unselected patients (24 men, 11 women; mean age, 51±18 years) with bacterial (n=33) or fungal (n=2) meningitis prospectively underwent serial transcranial Doppler sonography recordings of mean blood velocity (MBV) and pulsatility index in the middle (MCA) and anterior (ACA) cerebral arteries, as well as recordings of the ratio of the MBV of the MCA and internal carotid artery (MCA/ICA ratio) on days 1, 3, 5, 8, 14, and 21 after admission. The results were correlated with the Glasgow Coma Scale (days 1 to 14), the occurrence of focal cerebral signs, and the Glasgow Outcome Scale (short-term outcome, day 21). An MCA stenosis was diagnosed by an MBV of 120 cm/s or more or an MCA/ICA ratio of more than 3. An ACA stenosis was diagnosed by an MBV of 100 cm/s or more.
Results Transient stenoses occurred most frequently
between days 3 and 5 and were detected in 18 patients (51%). Seventeen
patients remained without a stenosis. Patients with
stenoses showed a significantly poorer mean Glasgow Coma Scale
score from day 3 (9±4) to day 14 (11±4) than patients without a
stenosis (day 3: 13±4, P<.01 by t test;
day 14: 14±1, P<.05). The mean Glasgow Outcome Scale score
was not significantly different between both groups. The occurrence of
mainly transient focal cerebral signs was significantly related to the
number of narrowed vessels per patient (P<.05,
2 test).
Conclusions Stenoses of the intracranial arteries occur frequently in bacterial meningitis and are associated with a complicated course of the disease.
Key Words: cerebral arteries • meningitis • ultrasonics • vasospasm
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  C.-H. Lu, H.-W. Chang, C.-C. Lui, C.-R. Huang, and W.-N. Chang Cerebral haemodynamics in acute bacterial meningitis in adults. QJM, December 1, 2006; 99(12): 863 - 869. [Abstract] [Full Text] [PDF]
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