Brain Computed Tomography Scan in Meningitis Patients with Deterioration Of Consciousness

IntroductionDue to life-threatening complication of LP in patients with deterioration of consciousness due to meningitis (=brain herniation) the LP procedure safety without brain CT scan is debated. Materials and MethodsThis descriptive cross-sectional study was done on patients suspected of meningitis with decreased consciousness referred to the infectious emergency of Emam Reza Hospital, Mashhad, Iran from April 2006 to March 2008. All patients underwent physical examination (neurologic and ophthalmoscopic) of the patients by residents of infectious diseases. Data (results of physical examination, neurologic, ophtalmoscopic, brain CT scan and LP) were collected. Then statistical analysis was performed with SPSS software and descriptive statistical methods. Results136 patients were evaluated. The mean age of patients was 43.88±21.185 years and 58.5% (24) of the cases were male. The result of brain CT was normal in 53.7%. The most frequent abnormal brain CT results were hypodencity lesions (12%). 2.4 % (1) of patients had abnormal CT-Scan with space occupying lesion with mass effect and midline shift, and final diagnosis was brain abscess due to chronic mastoiditis. ConclusionThis study showed that abnormal finding of brain CT-Scan in adult meningitis with loss of consciousness is approximately 50% and mass effect was seen in 2.4% of patients.