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Ischemic Cerebrovascular Complications of Haemophilus influenzae Meningitis: The Value of Computed Tomography

Ischemic Cerebrovascular Complications of Haemophilus influenzae Meningitis: The Value of... Abstract • In an effort to define the value of computed tomographic (CT) scanning in assessment of cerebral involvement in children with severe Haemophilus influenzae meningitis, we studied 12 children who had focal neurologic deficits on admission or within the early days of illness. The CT scan reliably excluded abscess and cerebritis and suggested ischemic cerebrovascular lesions in 11 of 12 children. Scans performed early in the hospital course generally showed low-density lesions occurring in a vascular distribution without detectable mass effect or enhancement. Later in the clinical course there was consistent enhancement of gray matter or diffuse enhancement in the area of the vascular lesion. The duration of symptoms of meningitis ranged from five to 21 days (mean, 13 days) and appeared to predispose to these vascular lesions. A CT scan consistent with infarction of brain parenchyma occurred predictably in patients with persistent focal neurologic deficits and was correlated with poor outcome. References 1. Feigin RD, Stechenberg BW, Chang M: Prospective evaluation of treatment of Hemophilus influenzae meningitis . J Pediatr 1976;88:542-548.Crossref 2. Herson VC, Todd JK: Prediction of morbidity in Hemophilus influenzae meningitis . Pediatrics 1977;59:35-39. 3. Lindberg J, Rosenhall U, Nylen O, et al: Longterm outcome of Hemophilus influenzae meningitis related to antibiotic treatment . Pediatrics 1977;60:1-6. 4. O'Reilly RJ, Anderson P, Ingram DL, et al: Circulating polyribophosphate in Hemophilus influenzae, type b meningitis . J Clin Invest 1975;56:1012-1022.Crossref 5. Ward JI, Siver GR, Scheifele DW, et al: Rapid diagnosis of Hemophilus influenzae type b infections by latex particle agglutination and counterimmunoelectrophoresis . J Pediatr 1978;93:37-42.Crossref 6. Snyder RD, Stovring J: The followup CT scan in childhood meningitis . Neuroradiology 1978;16:22-23.Crossref 7. Stovring J, Snyder RD: Computed tomography in childhood bacterial meningitis . J Pediatr 1980;96:820-823.Crossref 8. Weisberg LA: Cerebral computerized tomography in intracranial inflammatory disorders . Arch Neurol 1980;37:137-142.Crossref 9. Weisberg LA: Computerized tomographic enhancement patterns in cerebral infarction . Arch Neurol 1980;37:21-24.Crossref 10. Smith JF, Landing BH: Mechanisms of brain damage in H. influenzae meningitis . J Neuropathol Exp Neurol 1960;19:248-265.Crossref 11. Adams RD, Kubik CS, Bonner FJ: The clinical and pathological aspects of influenzal meningitis . Arch Pediatr 1948;65:354-380, 408-459. 12. Gado M, Axley J, Appleton DB, et al: Angiography in the acute and post-treatment phases of Hemophilus influenzae meningitis . Radiology 1974;110:439-444.Crossref 13. Milhorat TH: Pediatric Neurosurgery . Philadelphia, FA Davis Co, 1978, pp 356-357. 14. Lyons EL, Leeds NE: The angiographic demonstration of arterial vascular disease in purulent meningitis . Radiology 1967;88:935-938.Crossref 15. James AE, Hodges FJ, Jordan CE: Angiography and cisternography in acute meningitis due to Hemophilus influenzae . Radiology 1972;103:601-606.Crossref 16. Thomas VH, Hopkins IJ: Angiographic demonstration of vascular lesions in the study of neurologic deficit in advanced Hemophilus influenzae meningitis . Dev Med Child Neurol 1972;14:783-787.Crossref 17. Headings DL, Glasgow LA: Occlusion of the internal carotid artery complicating Hemophilus influenzae meningitis . Am J Dis Child 1977;131:854-856. 18. Berman PH, Banker BQ: Neonatal meningitis . Pediatrics 1966;38:6-24. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Ischemic Cerebrovascular Complications of Haemophilus influenzae Meningitis: The Value of Computed Tomography

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References (21)

Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1982.00510220048011
Publisher site
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Abstract

Abstract • In an effort to define the value of computed tomographic (CT) scanning in assessment of cerebral involvement in children with severe Haemophilus influenzae meningitis, we studied 12 children who had focal neurologic deficits on admission or within the early days of illness. The CT scan reliably excluded abscess and cerebritis and suggested ischemic cerebrovascular lesions in 11 of 12 children. Scans performed early in the hospital course generally showed low-density lesions occurring in a vascular distribution without detectable mass effect or enhancement. Later in the clinical course there was consistent enhancement of gray matter or diffuse enhancement in the area of the vascular lesion. The duration of symptoms of meningitis ranged from five to 21 days (mean, 13 days) and appeared to predispose to these vascular lesions. A CT scan consistent with infarction of brain parenchyma occurred predictably in patients with persistent focal neurologic deficits and was correlated with poor outcome. References 1. Feigin RD, Stechenberg BW, Chang M: Prospective evaluation of treatment of Hemophilus influenzae meningitis . J Pediatr 1976;88:542-548.Crossref 2. Herson VC, Todd JK: Prediction of morbidity in Hemophilus influenzae meningitis . Pediatrics 1977;59:35-39. 3. Lindberg J, Rosenhall U, Nylen O, et al: Longterm outcome of Hemophilus influenzae meningitis related to antibiotic treatment . Pediatrics 1977;60:1-6. 4. O'Reilly RJ, Anderson P, Ingram DL, et al: Circulating polyribophosphate in Hemophilus influenzae, type b meningitis . J Clin Invest 1975;56:1012-1022.Crossref 5. Ward JI, Siver GR, Scheifele DW, et al: Rapid diagnosis of Hemophilus influenzae type b infections by latex particle agglutination and counterimmunoelectrophoresis . J Pediatr 1978;93:37-42.Crossref 6. Snyder RD, Stovring J: The followup CT scan in childhood meningitis . Neuroradiology 1978;16:22-23.Crossref 7. Stovring J, Snyder RD: Computed tomography in childhood bacterial meningitis . J Pediatr 1980;96:820-823.Crossref 8. Weisberg LA: Cerebral computerized tomography in intracranial inflammatory disorders . Arch Neurol 1980;37:137-142.Crossref 9. Weisberg LA: Computerized tomographic enhancement patterns in cerebral infarction . Arch Neurol 1980;37:21-24.Crossref 10. Smith JF, Landing BH: Mechanisms of brain damage in H. influenzae meningitis . J Neuropathol Exp Neurol 1960;19:248-265.Crossref 11. Adams RD, Kubik CS, Bonner FJ: The clinical and pathological aspects of influenzal meningitis . Arch Pediatr 1948;65:354-380, 408-459. 12. Gado M, Axley J, Appleton DB, et al: Angiography in the acute and post-treatment phases of Hemophilus influenzae meningitis . Radiology 1974;110:439-444.Crossref 13. Milhorat TH: Pediatric Neurosurgery . Philadelphia, FA Davis Co, 1978, pp 356-357. 14. Lyons EL, Leeds NE: The angiographic demonstration of arterial vascular disease in purulent meningitis . Radiology 1967;88:935-938.Crossref 15. James AE, Hodges FJ, Jordan CE: Angiography and cisternography in acute meningitis due to Hemophilus influenzae . Radiology 1972;103:601-606.Crossref 16. Thomas VH, Hopkins IJ: Angiographic demonstration of vascular lesions in the study of neurologic deficit in advanced Hemophilus influenzae meningitis . Dev Med Child Neurol 1972;14:783-787.Crossref 17. Headings DL, Glasgow LA: Occlusion of the internal carotid artery complicating Hemophilus influenzae meningitis . Am J Dis Child 1977;131:854-856. 18. Berman PH, Banker BQ: Neonatal meningitis . Pediatrics 1966;38:6-24.

Journal

Archives of Neurology – American Medical Association

Published: Oct 1, 1982

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