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Abnormalities of cerebral blood flow in the acute phase of bacterial meningitis in adults

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Summary

The frequency, course and clinical significance of changes in regional cerebral blood flow (rCBF) during bacterial meningitis were investigated in 14 adult patients. The results of99mTc-hexamethylpropylene amine oxime (HMPAO) single photon emission computed tomography (SPECT) were compared with the clinical signs and findings using cerebral angiography and conventional CT. HMPAO SPECT was performed 2–15 days (median 4.5 days) after the onset of neurological disease. Decreased HMPAO accumulation was detected in 13 patients. SPECT studies revealed focal hypoperfusion cor responding to the clinical symptoms in 6 patients suffering from hemiparesis or hemiataxia. Conventional cranial CT disclosed brain infarction in only 1 patient. Focal hypoperfusion was also found in 7 of 8 patients without clinical evidence of focal neurological deficits. In 6 patients, HMPAO SPECT findings were abnormal although cerebral angiography was normal. At follow-up examinations 3–45 weeks after the acute disease, abnormalities revealed by HMPAO SPECT had improved or had even disappeared in all patients studied. Our results indicate that reduced rCBF is a frequent finding in bacterial meningitis in the adult. In most patients it probably represents a functional and reversible disorder without structural lesion detectable on CT.

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Authors and Affiliations

  1. Neurologische Klinik, Klinikum Grosshadern, Ludwig-Maximilians-Universität, Marchioninistrasse 15, W-8000, München 70, Germany

    S. Förderreuthert, K. M. Einhäupl & H. W. Pfister

  2. Abteilung für Nuklearmedizin, Radiologische Klinik, Klinikum Grosshadern, Ludwig-Maximilians-Universität, Marchioninistrasse 15, W-8000, München 70, Germany

    K. Tatsch

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  4. H. W. Pfister
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Förderreuthert, S., Tatsch, K., Einhäupl, K.M. et al. Abnormalities of cerebral blood flow in the acute phase of bacterial meningitis in adults. J Neurol 239, 431–436 (1992). https://doi.org/10.1007/BF00856807

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