Abstract
Cerebrovascular alterations are frequent in bacterial meningitis and found in roughly 50% of these patients. In viral meningitis, they are rare. When present, arterial alterations are associated with a more severe clinical cause, a poorer outcome, and with the occurrence of strokes. The characteristic finding of arterial narrowing consists of a blood velocity increase from day 1 to day 6 and can persist until day 21. In some cases, the latter are present for several weeks or months and may at this time point represent a definitive stenotic arteriopathy. Causative pathogens more frequently associated with arterial narrowing are Streptococcus pneumoniae, Neisseria meningitidis, Mycobacterium tuberculosis, Cryptococcus, Treponema pallidum and Borrelia burgdorferi, Varicella zoster virus, Herpes simplex virus, and HIV(irus), and Cysticercosis due to Taenia solium. Although recommended, it is unclear whether adjunctive steroid therapy is helpful to prevent negative effects of vascular alterations.
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ABCD Airway-breathing-circulation-disability, PI Pulsatility index, GCS Glasgow coma scale, RASS Richmond agitation and sedation scale, ICP Intracranial pressure, CO Cardiac output, IV Intravenous, BCTS Brain computed tomography scan, CSF Cerebral spinal fluid, ABC Airway-breathing-circulation, CBFV Cerebral blood flow velocity
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Müller, M., Österreich, M., Lakatos, L., Bolognese, M. (2022). Central Nervous System Infection in ICU: Usefulness of Transcranial Doppler (TCD/TCCS) to Cerebral Hemodynamics Monitoring. In: RodrÃguez, C.N., et al. Neurosonology in Critical Care . Springer, Cham. https://doi.org/10.1007/978-3-030-81419-9_69
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DOI: https://doi.org/10.1007/978-3-030-81419-9_69
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