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The Use of Clinical Scales in Depicting Cerebrovascular Complications in Bacterial Meningitis
Author(s) -
Merkelbach Stefan,
König Jochem,
Röhn Sonja,
Müller Martin
Publication year - 2001
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/j.1552-6569.2001.tb00005.x
Subject(s) - medicine , glasgow coma scale , sss* , transcranial doppler , glasgow outcome scale , meningitis , coma (optics) , bacteremia , middle cerebral artery , bacterial meningitis , cerebral blood flow , anesthesia , stroke (engine) , cardiology , surgery , ischemia , physics , microbiology and biotechnology , optics , biology , antibiotics , mechanical engineering , engineering
To evaluate the utility of different scales for clinical assessment, over time, in acute bacterial meningitis, the authors investigated 53 consecutive patients (mean age 53 ± 17 years). Clinical status on days 1, 3, 5, 8, and 14 after admission was determined by the Scandinavian Stroke Scale (SSS), Glasgow Coma Scale (GCS), and Hunt and Hess Scale (HH), and, on day 21, by the Glasgow Outcome Scale (GOS). Transcranial Doppler examinations were performed serially to assess for disease‐related arterial narrowing. This was observed in 27 patients (51%) within 2 weeks of admission. All scales were observed to correlate with the 21‐day GOS. Patients with cerebral arterial narrowing had significantly decreased SSS scores between days 1 and 8 and worse GCS and HH scores between days 3 and 5. Mean blood flow velocity in the middle cerebral artery on days 5 and 8 significantly correlated with GOS ( r = 0.268, P < .008; r =−0.324, P < .003, respectively). The use of such clinical scales allows standardized assessment of patients with bacterial meningitis and provides prognostic information. Cerebral arterial narrowing was observed to correlate with neurologic impairment.