Bacterial meningitis CT
Bacterial meningitis Microchapters
CT scan may help identify the patients with bacterial meningitis who are at increased risk of cerebral herniation with lumbar puncture. Routine screening with CT scan may be indicated in such patients before undergoing lumbar puncture. Ct scan may also help to identify the complications of bacterial meningitis such as epidural empyema, subdural empyema, ventriculitis and cerebral abscess.
Routine screening with CT scan may not be indicated in all patients with bacterial meningitis. However, it may be indicated in patients with suspected case of bacterial meningitis to exclude mass lesions and increased intracranial pressure before a lumbar puncture to prevent cerebral herniation. According to Infectious disease society of America guidelines 2004, the presence of following risk factors may necessitate the CT scan before undergoing lumbar puncture:
- Sudden onset seizures
- Known history of mass lesion or stroke
- Immunosuppression(HIV, organ transplant, steroid therapy )
- Focal neurological deficit
- Altered level of consciousness
CT scan findings which may help diagnose patients with bacterial meningitis and its complications may include the following:
- May be normal
- Subtle hydrocephalus
- Hyperdensity around basal cisterns (tuberculous meningitis)
- Leptomeningeal enhancement
- Complications (such as epidural empyema, subdural empyema, cerebritis or cerebral abscess, infarction, ventriculitis, dural sinus thrombosis)
- Nagra I, Wee B, Short J, Banerjee AK (2011). "The role of cranial CT in the investigation of meningitis". JRSM Short Rep. 2 (3): 20. doi:10.1258/shorts.2011.010113. PMC 3086327. PMID 21541088.
- Kastrup O, Wanke I, Maschke M (2005). "Neuroimaging of infections". NeuroRx. 2 (2): 324–32. doi:10.1602/neurorx.2.2.324. PMC 1064994. PMID 15897953.
- Hughes DC, Raghavan A, Mordekar SR, Griffiths PD, Connolly DJ (2010). "Role of imaging in the diagnosis of acute bacterial meningitis and its complications". Postgrad Med J. 86 (1018): 478–85. doi:10.1136/pgmj.2010.097022. PMID 20709770.
- https://radiopaedia.org/articles/leptomeningitis Accessed on Jan 9th, 2017