&lt;b&gt;&lt;i&gt;Streptococcus pneumoniae&lt;/i&gt;&lt;/b&gt; Meningitis and Intracranial Vasculopathy: Clinical Correlation with Improving Transcranial Doppler Hemodynamics

Idris, Mohamad Imran; Tai, Sharon Mei Ling; Tan, Chong Tin; Tan, Kay Sin

doi:10.1159/000500950

Cited by 6 publications

(4 citation statements)

References 5 publications

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“…Tuberculous meningitis should be suspected in patients with stroke occurring 10–14 days after a meningitic syndrome and fever [ 127 ]. Rarely, IS occurs as a complication of bacterial meningitis [ 128 , 129 ].…”

Section: Spectrum Of Cerebrovascular Diseases In Asiamentioning

confidence: 99%

Stroke in Asia

Tan,

Pandian,

Liu

et al. 2024

Cerebrovasc Dis Extra

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Background There is a significant burden of stroke in Asia. Asia has the largest population in the world in 2023, estimated at 4.7 billion. Approximately 9.5-10.6 million strokes will be anticipated annually in the backdrop of a diverse group of well-developed and less developed countries with large disparities in stroke care resources. In addition, Asian countries are in varying phases of epidemiological transition. Summary In this review, we examined recent epidemiological features of ischaemic stroke and intracerebral haemorrhage in Asia with recent developments in hyperacute stroke reperfusion therapy and technical improvements in intracerebral haemorrhage. The article also discussed the spectrum of cerebrovascular diseases in Asia which include intracranial atherosclerosis, intracerebral haemorrhage, infective aetiologies of stroke, moyamoya disease, vascular dissection, radiation vasculopathy and cerebral venous thrombosis. Key Messages The review of selected literature and recent updates, call for attention to the different requirements for resources within Asia and highlights the breadth of cerebrovascular diseases still requiring further research and more effective therapies,

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Section: Spectrum Of Cerebrovascular Diseases In Asiamentioning

confidence: 99%

Stroke in Asia

Tan,

Pandian,

Liu

et al. 2024

Cerebrovasc Dis Extra

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“…This persistent inflammatory state results in cerebral edema, increased intracranial pressure, decreased cerebral perfusion, vasculitis, and vasospasm. 3 , 7 …”

Section: Introductionmentioning

confidence: 99%

A Severe Case of Streptococcus pneumoniae Meningoencephalitis in an Infant Resulting in Fatal Strokes

Goodman,

Garcia,

Wang

et al. 2024

Child Neurology Open

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Streptococcus pneumoniae (S. Pneumoniae) is a common cause of bacterial meningitis in the pediatric population, but rarely causes complications such as encephalitis, abscess, and seizures with the prompt initiation of proper antimicrobial therapy. In this report, we present a rare and severe case of S. Pneumoniae meningoencephalitis in a full term 6-month-old which progressed to multiple cerebral and cerebellar infarcts with concomitant cerebellar tonsillar herniation and hypercarbic respiratory failure requiring intubation and mechanical ventilation despite early initiation of antibiotics. Given the patient's clinical status and poor neurological prognosis, the family eventually opted for palliative extubation.

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“…Intracranial vasculopathy is an important complication of bacterial meningitis, since it increases the risk of stroke and worsens prognosis. 5 This can be detected by transcranial Doppler (TCD) ultrasonography, a procedure that is non-invasive, readily available, 6 and provides real-time data on cerebral hemodynamics. TCD is useful in detecting various cerebral arterial abnormalities that can occur in patients with intracranial vasculopathy, such as vasospasm, hyperemia, and microemboli.…”

Section: Introductionmentioning

confidence: 99%

“…Intracranial vasculopathy is an important complication of bacterial meningitis, since it increases the risk of stroke and worsens prognosis 5 . This can be detected by transcranial Doppler (TCD) ultrasonography, a procedure that is non‐invasive, readily available, 6 and provides real‐time data on cerebral hemodynamics.…”

Section: Introductionmentioning

confidence: 99%

Transcranial Doppler ultrasonography in bacterial meningitis: A systematic review

Batino,

Cinco,

Navarro

et al. 2023

J of Clinical Ultrasound

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PurposeBacterial meningitis remains a global threat due to its high mortality. It is estimated that >1.2 million cases of bacterial meningitis are reported annually. Intracranial vasculopathy is an important, under‐documented complication, easily detected by transcranial Doppler (TCD) ultrasonography. Following the PRISMA Guidelines, we reviewed the utility of TCD in bacterial meningitis.MethodsThis is a systematic review of observational studies on the use of TCD in patients with CSF‐proven bacterial meningitis. Characteristic changes in TCD parameters along the course of the disease, correlation of TCD findings with neuroimaging, and functional outcomes were evaluated.ResultsNine studies were included with a total of 492 participants (mean age of 42). The most common TCD finding was intracranial arterial stenosis of the MCA (50%–82%) and ischemia (33%) was the predominant neuroimaging finding. The presence of an abnormal TCD finding increased the risk of poor outcomes as high as 70%.ConclusionsPatients diagnosed with bacterial meningitis who underwent TCD show alterations in cerebral blood flow, correlating with imaging findings and poor outcomes. It aids in the diagnosis of its sequelae and can predict the prognosis of its outcome. TCD is a cost‐effective, reliable modality for diagnosing vasculopathy associated with bacterial meningitis. It may prove useful in our armamentarium of management. Large prospective studies with long‐term follow‐up data may help establish the use of TCD in bacterial meningitis.

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<b><i>Streptococcus pneumoniae</i></b> Meningitis and Intracranial Vasculopathy: Clinical Correlation with Improving Transcranial Doppler Hemodynamics

Cited by 6 publications

References 5 publications

Stroke in Asia

Stroke in Asia

A Severe Case of Streptococcus pneumoniae Meningoencephalitis in an Infant Resulting in Fatal Strokes

Transcranial Doppler ultrasonography in bacterial meningitis: A systematic review

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