The role of CT in the acute management of bacterial meningitis in 30 children was evaluated at the Department of Pediatrics, St. Mary’s Hospital Medical School, London, England. Cranial CT was normal in 10 patients, 5 with raised intracranial pressure, 1 with focal neurological signs and 1 with generalized convulsions. Significant CT abnormalities were detected in 10 patients, 4 with subdural effusion, 4 with cerebral infarct, 1 hydrocephalus, and 1 empyema. CT identified a surgical abnormality in 2 patients with progressive focal neurological signs. [1]

COMMENT. This study shows that the role of CT in the management of acute bacterial meningitis is limited, but may be valuable in those with progressive neurological signs for whom neurosurgical intervention may be necessary.

The long-term follow-up of acute bacterial meningitis in 74 children is reported from Taiyuan City, China [2]. Neurologic sequelae occurred in 33.8% of survivors: 54% had mental retardation, 50% epilepsy, 33% paralysis, 16% sensorineural hearing loss and 4% blindness. Other abnormalities included growth retardation, hyperactivity and irritability. Dexamethasone reduced the incidence of hearing loss.

Cranial CT conducted in 199 children with tuberculous meningitis in Cape Town, Republic of South Africa, showed basal ganglia infarcts in 30%, which corresponded with hemiplegia. [3]