All issues > Volume 30(6); 1987

Original Article

J Korean Pediatr Soc. 1987;30(6):640-650. Published online June 30, 1987.

Significance of Brain CT in Children with Meningitig.

Myeong Yeon Lee¹, Byoung Soo Cho¹, Sa Jun Chung¹, Yong Mook Choi¹, Chang Il Ahn¹

¹Department of Pediatrics, School of Medicine, Kyung Hee University, Seoul, Korea

Abstract

This study was undertaken to evaluate the significance of brain CT in children with meningitis. The findings of brain CT in 71 children with meningitis were evaluated in relation to the clinical outcome. We divided 71 cases into 5 groups according to clinical outcome on discharge, that is, Group I: Recovery. Group II: Discharge with improvement. Group III: Discharge with residual sequalae. Group IV: Discharge with moribund. Group V: Expired. The brain CT findings were retrospectively analyzed and compared with clinical outcome on discharge. The results were as follows; 1) Male to female ratio was 1.4:1 and age distribution was 24 cases in below 1 year of age, 31 cases in 1 to 5 years of age, 9 cases in 5 to 10 years of age, and 7 cases in 10 to 15 years of age. The common age group which resulted in meningitis was infancy in bacterial meningitis and 1 to 5 years of age in tuberculous meningitis. 2) The case distribution was 7 cases in viral meningitis, 22 cases in bacterial meningitis, and 42cases in tuberculous meningitis. 3) The cases distribution by clinical outcome and causative agents was follows; 13 cases (59%) of bacterial meningitis were Group III, IV, and V, and all of viral meningitis were Group I, 28 cases (66%) of tuberculous meningitis were Group III, IV, and V. 4) The worst prognostic brain CT findings was cisternal enhancement (Group III, IV, and V: 89%). 5) CT findings of obliteration of cistern, hydrocephalus, granuloma, brain atrophy, subdural effusion, brain swelling, and subdural abscess were showed in unfavorable outcome and which were noted frequently in Group III, IV, and V. 6) Periventricular low density, calcification, gyral enhancement, and ventricular wall enhancement showed favorable clinical outcome. 7) Patients with normal brain CT findings were belonged to Group I, resulted in good prognosis. 8) Cisternal enhancement, obliteration of cistern, hydrocephalus, brain atrophy, calcification, and brain swelling were more frequent findings in tuberculous meningitis. Subdural effusioin, subdural abscess, and periventricular wall enhancement were more frequent findings in bacterial meningitis. 9) In viral meningitis, all showed normal findings except calcification (1 case) and gyral enhancement (1 case). 10) Cisternal enhancement was associated with hydrocephalus, granuloma, cerebral infarction, subdural abscess, and subdural effusion.

Keywords :Meningitis; Brain Computed Tomography (CT) finding.