Transcranial Doppler Ultrasonographic Evaluation of Cerebrovascular Abnormalities in Children With Acute Bacterial Meningitis
Bodi Mabiala, Joseph
Gushu, Montfort Bernard
Chikaonda, Bertha Mekiseni
Ambitapio Musungufu, Davin
O'Brien, Nicole Fortier
JournalFrontiers in Neurology
PublisherFrontiers Media S.A.
MetadataShow full item record
AbstractIntroduction: 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. Methods: 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. Results: Forty-seven patients were analyzed. The majority had Streptococcus pneumoniae (36%) or Neisseria meningitides (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%, p = 0.001). Conclusions: Abnormal TCD flow patterns were common in children with BM and identified those at high risk of poor neurological outcome.
Rights/TermsCopyright © 2021 Fonseca, Tshimanga, Ray, Malhotra, Pongo, Bodi Mabiala, Gushu, Phiri, Chikaonda, Ambitapio Musungufu, Uchama and O'Brien.
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/14971
- Mechanisms of Transcranial Doppler Ultrasound phenotypes in paediatric cerebral malaria remain elusive.
- Authors: O'Brien NF, Fonseca Y, Johnson HC, Postels D, Birbeck GL, Chimalizeni Y, Seydel KB, Bernard Gushu M, Phiri T, June S, Chetcuti K, Vidal L, Goyal MS, Taylor TE
- Issue date: 2022 Jun 21
- Cerebrovascular involvement in the acute phase of bacterial meningitis.
- Authors: Ries S, Schminke U, Fassbender K, Daffertshofer M, Steinke W, Hennerici M
- Issue date: 1997 Jan
- Noninvasive screening for intracranial hypertension in children with acute, severe traumatic brain injury.
- Authors: O'Brien NF, Maa T, Reuter-Rice K
- Issue date: 2015 Oct
- Transcranial Doppler sonography at the early stage of acute central nervous system infections in adults.
- Authors: Müller M, Merkelbach S, Hermes M, Schimrigk K
- Issue date: 1996
- Post-intervention TCD examination may be useful to predict outcome in acute ischemic stroke patients with successful intra-arterial intervention.
- Authors: Aoki J, Raber LN, Katzan IL, Hussain MS, Hui FK, Uchino K
- Issue date: 2013 Nov 15