Abstract：
OBJECTIVE: Bacterial meningitis remains a global threat due to its high mortality. It is estimated that >1.2 million cases of bacterial meningitis are reported annually. Intracranial vasculopathy is an important, under-documented complication, easily detected by transcranial Doppler (TCD) ultrasonography. Following the PRISMA Guidelines, we reviewed the utility of TCD in bacterial meningitis.
METHODS: This is a systematic review of observational studies on the use of TCD in patients with CSF-proven bacterial meningitis. Characteristic changes in TCD parameters along the course of the disease, correlation of TCD findings with neuroimaging, and functional outcomes were evaluated.
RESULTS: Nine studies were included with a total of 492 participants (mean age of 42). The most common TCD finding was intracranial arterial stenosis of the MCA (50%-82%) and ischemia (33%) was the predominant neuroimaging finding. The presence of an abnormal TCD finding increased the risk of poor outcomes as high as 70%.
CONCLUSIONS: Patients diagnosed with bacterial meningitis who underwent TCD show alterations in cerebral blood flow, correlating with imaging findings and poor outcomes. It aids in the diagnosis of its sequelae and can predict the prognosis of its outcome. TCD is a cost-effective, reliable modality for diagnosing vasculopathy associated with bacterial meningitis. It may prove useful in our armamentarium of management. Large prospective studies with long-term follow-up data may help establish the use of TCD in bacterial meningitis.
METHODS: This is a systematic review of observational studies on the use of TCD in patients with CSF-proven bacterial meningitis. Characteristic changes in TCD parameters along the course of the disease, correlation of TCD findings with neuroimaging, and functional outcomes were evaluated.
RESULTS: Nine studies were included with a total of 492 participants (mean age of 42). The most common TCD finding was intracranial arterial stenosis of the MCA (50%-82%) and ischemia (33%) was the predominant neuroimaging finding. The presence of an abnormal TCD finding increased the risk of poor outcomes as high as 70%.
CONCLUSIONS: Patients diagnosed with bacterial meningitis who underwent TCD show alterations in cerebral blood flow, correlating with imaging findings and poor outcomes. It aids in the diagnosis of its sequelae and can predict the prognosis of its outcome. TCD is a cost-effective, reliable modality for diagnosing vasculopathy associated with bacterial meningitis. It may prove useful in our armamentarium of management. Large prospective studies with long-term follow-up data may help establish the use of TCD in bacterial meningitis.
摘要：
目的：细菌性脑膜炎由于其高死亡率仍然是全球威胁。据估计，每年报告的细菌性脑膜炎病例超过120万例。颅内血管病变是重要的,记录不足的并发症，经颅多普勒（TCD）超声检查容易发现。根据PRISMA准则，我们回顾了TCD在细菌性脑膜炎中的应用。
方法：这是一项关于在CSF证实的细菌性脑膜炎患者中使用TCD的观察性研究的系统综述。TCD参数在病程中的特征性变化，TCD发现与神经影像学的相关性，和功能结果进行了评估。
结果：纳入9项研究，共492名参与者（平均年龄42岁）。最常见的TCD发现是MCA的颅内动脉狭窄（50％-82％），而缺血（33％）是主要的神经影像学发现。异常TCD发现的存在会增加不良结局的风险高达70％。
结论：诊断为细菌性脑膜炎并接受TCD的患者脑血流改变，与影像学发现和不良结局相关。它有助于诊断其后遗症，并可以预测其预后。TCD是一种划算的，诊断与细菌性脑膜炎相关的血管病变的可靠方法。它可能在我们的管理设备中有用。具有长期随访数据的大型前瞻性研究可能有助于确定TCD在细菌性脑膜炎中的应用。
方法：这是一项关于在CSF证实的细菌性脑膜炎患者中使用TCD的观察性研究的系统综述。TCD参数在病程中的特征性变化，TCD发现与神经影像学的相关性，和功能结果进行了评估。
结果：纳入9项研究，共492名参与者（平均年龄42岁）。最常见的TCD发现是MCA的颅内动脉狭窄（50％-82％），而缺血（33％）是主要的神经影像学发现。异常TCD发现的存在会增加不良结局的风险高达70％。
结论：诊断为细菌性脑膜炎并接受TCD的患者脑血流改变，与影像学发现和不良结局相关。它有助于诊断其后遗症，并可以预测其预后。TCD是一种划算的，诊断与细菌性脑膜炎相关的血管病变的可靠方法。它可能在我们的管理设备中有用。具有长期随访数据的大型前瞻性研究可能有助于确定TCD在细菌性脑膜炎中的应用。
