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Naso-orbital Hemangioma
Joseph Junewick, MD FACR
over 8 years ago
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Group B Streptococcus Meningitis

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Infectious-Inflammatory
Created: over 6 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: US
Activities:
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History

Fullterm newborn with myelomeningocele.


Case Images


Diagnosis

Group B Streptococcus Meningitis

Clinical Notes

Mother colonized with group B streptococcus.

Findings

US – Multifocal hyperechoic lesions, effaced sulci, marked hyperemia on color Doppler and elevated anterior cerebral artery diastolic flow. The dilated and dysmorphic ventricles may be related to meningitis and/or underlying Chiari malformation.

Discussion

The pathophysiology of meningitis is complex. The choroid plexus is most often seeded during sepsis with eventual development of arachnoiditis, ventriculitis, vasculitis and/or thrombophlebitis. Inflammatory mediators (cytokines) and bacterial toxins accentuate the inflammatory process, alter vasogenic stability, disrupt the blood-brain barrier and cause to edema. US findings in meningitis include: pia-arachnoid thickening (>1.3 mm over convexity or >2 mm in a sulcus), reactive hygroma, subdural empyema, thickened and irregular ependyma, intraventricular debris, intraventricular adhesions, hydrocephalus, focal or diffuse infarcts (venous or arterial), parenchymal edema, abscess, pia-arachnoid hyperemia, increased diastolic flow (loss of autoregulation) and decreased diastolic flow (increased intracranial pressure and edema).

Reference

Yikilmaz A, Taylor GA. Sonographic findings in bacterial meningitis in neonates and young infants. Pediatr Radiol (2008); 38:129-137.



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