Transcranial Doppler Ultrasonographic Evaluation of Cerebrovascular Abnormalities in Children With Acute Bacterial Meningitis

Fonseca, Yudy, Tshimanga, Taty, Ray, Stephen, Malhotra, Helen, Pongo, Jean, Bodi Mabiala, Joseph, Gushu, Montfort Bernard, Phiri, Tusekile, Chikaonda, Bertha Mekiseni, Ambitapio Musungufu, Davin
et al (show 2 more authors) (2020) Transcranial Doppler Ultrasonographic Evaluation of Cerebrovascular Abnormalities in Children With Acute Bacterial Meningitis. Frontiers in Neurology, 11. 558857-.

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<jats:p><jats:bold>Introduction:</jats:bold> Bacterial meningitis (BM) is a global public health concern that results in significant morbidity and mortality. Cerebral arterial narrowing contributes to stroke in BM and may be amenable to intervention. However, it is difficult to diagnose in resource-limited settings where the disease is common.</jats:p><jats:p><jats:bold>Methods:</jats:bold> This was a prospective observational study from September 2015 to December 2019 in sub-Saharan Africa. Children 1 month−18 years of age with neutrophilic pleocytosis or a bacterial pathogen identified in the cerebrospinal fluid were enrolled. Transcranial Doppler ultrasound (TCD) of the middle cerebral arteries was performed daily with the aim to identify flow abnormalities consistent with vascular narrowing.</jats:p><jats:p><jats:bold>Results:</jats:bold> Forty-seven patients were analyzed. The majority had <jats:italic>Streptococcus pneumoniae</jats:italic> (36%) or <jats:italic>Neisseria meningitides</jats:italic> (36%) meningitis. Admission TCD was normal in 10 (21%). High flow with a normal pulsatility index (PI) was seen in 20 (43%) and high flow with a low PI was identified in 7 (15%). Ten (21%) had low flow. All children with a normal TCD had a good outcome. Patients with a high-risk TCD flow pattern (high flow/low PI or low flow) were more likely to have a poor outcome (82 vs. 38%, <jats:italic>p</jats:italic> = 0.001).</jats:p><jats:p><jats:bold>Conclusions:</jats:bold> Abnormal TCD flow patterns were common in children with BM and identified those at high risk of poor neurological outcome.</jats:p>

Item Type: Article
Uncontrolled Keywords: bacterial, meningitis, neurovascular, pediatrics, transcranial Doppler ultrasound
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 02 Aug 2021 10:33
Last Modified: 01 Mar 2024 18:08
DOI: 10.3389/fneur.2020.558857
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