Bacterial meningitis CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

CT scan

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 pncture to prevent cerebral herniation. Presence of following risk factors may necessitate the CT scan before undergoing lumbar puncture:

• Papilledema
• 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)

References

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