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Arterial cerebrovascular complications in 94 adults with acute bacterial meningitis

INTRODUCTION: Intracranial vascular complications are an important complication of acute bacterial meningitis. Ischemic stroke in meningitis is reported as a result of vasculitis, vasospasm, endocarditis or intraarterial thrombosis. The aim of the study was to identify the value of measuring cerebra...

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Autores principales: Klein, Matthias, Koedel, Uwe, Pfefferkorn, Thomas, Zeller, Grete, Woehrl, Bianca, Pfister, Hans-Walter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388646/
https://www.ncbi.nlm.nih.gov/pubmed/22112693
http://dx.doi.org/10.1186/cc10565
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author Klein, Matthias
Koedel, Uwe
Pfefferkorn, Thomas
Zeller, Grete
Woehrl, Bianca
Pfister, Hans-Walter
author_facet Klein, Matthias
Koedel, Uwe
Pfefferkorn, Thomas
Zeller, Grete
Woehrl, Bianca
Pfister, Hans-Walter
author_sort Klein, Matthias
collection PubMed
description INTRODUCTION: Intracranial vascular complications are an important complication of acute bacterial meningitis. Ischemic stroke in meningitis is reported as a result of vasculitis, vasospasm, endocarditis or intraarterial thrombosis. The aim of the study was to identify the value of measuring cerebral blood flow velocity (CBFv) on transracranial doppler (TCD) in the identification of patients at risk for meningitis-associated stroke. METHODS: We retrospectively studied patients with acute bacterial meningitis who were treated in our university hospital from 2000 to 2009. Data were analyzed with the main focus on the incidence of an increase of CBFv on TCD, defined as peak systolic values above 150 cm/s, and the development of stroke. RESULTS: In total, 114 patients with acute bacterial meningitis were treated, 94 of them received routine TCD studies during their hospital stay. 41/94 patients had elevated CBFv values. This increase was associated with an increased risk of stroke (odds ratio (95% confidence intervall) = 9.15 (1.96-42.67); p < 0.001) and unfavorable outcome (Glasgow Outcome Score < 4; odds ratio (95% confidence intervall) = 2.93 (1.23-6.98); p = 0.018). 11/32 (34.4%) patients with an increase of CBFv who received nimodipine and 2/9 (22.2%) patients with an increase of CBFv who did not receive nimodipine developed stroke (p = 0.69). CONCLUSIONS: In summary, TCD was found to be a valuable bedside test to detect arterial alterations in patients with bacterial meningitis. These patients have an increased risk of stroke.
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spelling pubmed-33886462012-07-04 Arterial cerebrovascular complications in 94 adults with acute bacterial meningitis Klein, Matthias Koedel, Uwe Pfefferkorn, Thomas Zeller, Grete Woehrl, Bianca Pfister, Hans-Walter Crit Care Research INTRODUCTION: Intracranial vascular complications are an important complication of acute bacterial meningitis. Ischemic stroke in meningitis is reported as a result of vasculitis, vasospasm, endocarditis or intraarterial thrombosis. The aim of the study was to identify the value of measuring cerebral blood flow velocity (CBFv) on transracranial doppler (TCD) in the identification of patients at risk for meningitis-associated stroke. METHODS: We retrospectively studied patients with acute bacterial meningitis who were treated in our university hospital from 2000 to 2009. Data were analyzed with the main focus on the incidence of an increase of CBFv on TCD, defined as peak systolic values above 150 cm/s, and the development of stroke. RESULTS: In total, 114 patients with acute bacterial meningitis were treated, 94 of them received routine TCD studies during their hospital stay. 41/94 patients had elevated CBFv values. This increase was associated with an increased risk of stroke (odds ratio (95% confidence intervall) = 9.15 (1.96-42.67); p < 0.001) and unfavorable outcome (Glasgow Outcome Score < 4; odds ratio (95% confidence intervall) = 2.93 (1.23-6.98); p = 0.018). 11/32 (34.4%) patients with an increase of CBFv who received nimodipine and 2/9 (22.2%) patients with an increase of CBFv who did not receive nimodipine developed stroke (p = 0.69). CONCLUSIONS: In summary, TCD was found to be a valuable bedside test to detect arterial alterations in patients with bacterial meningitis. These patients have an increased risk of stroke. BioMed Central 2011 2011-11-23 /pmc/articles/PMC3388646/ /pubmed/22112693 http://dx.doi.org/10.1186/cc10565 Text en Copyright ©2011 Klein et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Klein, Matthias
Koedel, Uwe
Pfefferkorn, Thomas
Zeller, Grete
Woehrl, Bianca
Pfister, Hans-Walter
Arterial cerebrovascular complications in 94 adults with acute bacterial meningitis
title Arterial cerebrovascular complications in 94 adults with acute bacterial meningitis
title_full Arterial cerebrovascular complications in 94 adults with acute bacterial meningitis
title_fullStr Arterial cerebrovascular complications in 94 adults with acute bacterial meningitis
title_full_unstemmed Arterial cerebrovascular complications in 94 adults with acute bacterial meningitis
title_short Arterial cerebrovascular complications in 94 adults with acute bacterial meningitis
title_sort arterial cerebrovascular complications in 94 adults with acute bacterial meningitis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388646/
https://www.ncbi.nlm.nih.gov/pubmed/22112693
http://dx.doi.org/10.1186/cc10565
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