How is cerebral infarction diagnosed in Haemophilus influenzae type b (Hib) meningitis?

Updated: Jul 09, 2018
  • Author: Prateek Lohia, MD, MHA; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Cerebral infarction as a consequence of meningitic vasculitis may be found. CT scanning may show low-density lesions corresponding to a particular vascular territory. Hib meningitis–associated infarction tends to be found in the subcortical white matter, cerebellum, and brainstem. Administration of contrast results in gyriform, nodular, or ring enhancement of the infracted area. Infarctions may be hemorrhagic, a feature that CT scanning is particularly likely to reveal.

MRI is more likely to demonstrate bland infarction, particularly when sequences designed to demonstrate restricted diffusion are employed. These abnormalities tend to be found in subcortical white matter, cerebellum, and brainstem and resemble the changes that may be found in hypoxic-ischemic encephalopathy. Lesions such as these should be suspected when patients with Hib meningitis manifest focal deficits or seizures.


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