ABSTRACT
Background: Recurrent bacterial meningitis (R.B.M) is an uncommon but life-threatening condition. R.B.M may be the result of developmental and traumatic defects which provide portals of bacterial invasion to cerebrospinal fluid (C.S.F). An undiagnosed immunologic deficiency may allow the host to be susceptible to potential pathogens of meningitis. Early diagnosis is crucial to prevent any further episodes and serious sequelae.
Aim of work: The aim of the present work was to evaluate the accuracy of C.T scan in detection of skull base defect in R.B.M.
Method: Eight patients with R.B.M were included in this study. After resolution of the last attack, all patients were subjected to full history taking, full neurological and E.N.T examinations, laboratory investigations for immunological evaluation and abdominal ultrasound. All patients were subjected to C.T scan for brain and skull base. The helical C.T scanners used in this study, single, 4, 64 slices and C.T metrizamide (C.T.M).
Results: There were 5 male and 3 female patients. Their ages ranged from 9 to 17 years. All cases had 2 attacks except 2 cases with 3 attacks. There were traumatic group included 3 cases (2 cases with C.S.F leak and one occult case), and congenital group included 5 cases (2 cases with C.S.F leak and occult 3 cases). The four cases with C.S.F leak were sub classified into two groups equal in number, traumatic and spontaneous groups. The 64 slice scanner detected the defects in 6 cases, while C.T.M detected the defects in all cases.
Conclusion: In R.B.M with absence of history of trauma, C.S.F leak and immunodeficiency conditions did not exclude the presence of anatomic defects. The 64 slice scanner was sensitive to small cranial dural defects, while C.T.M was sensitive and specific for defect localization.
Keywords: Recurrent bacterial meningitis, C.T evaluation.