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NEUROLOGY 2004;62:509-511
© 2004 American Academy of Neurology
Brief Communications

Axonal injury, a neglected cause of CNS damage in bacterial meningitis

Roland Nau, MD, Joachim Gerber, MD, Stephanie Bunkowski and Wolfgang Brück, MD

From the Departments of Neurology (Drs. Nau and Gerber, S. Bunkowski) and Neuropathology (Dr. Brück), University of Göttingen, Germany.

Address correspondence and reprint requests to Dr. R. Nau, Department of Neurology, University Hospital, Robert-Koch-Str. 40, 37075 Goettingen, Germany; e-mail: rnau{at}gwdg.de

The contribution of axonal injury to CNS damage in bacterial meningitis was studied by histology and immunohistochemistry for amyloid-ß precursor protein in humans and experimental rabbits. Axonal injury in the white matter caused predominantly but not exclusively by ischemia was detected in all autopsy cases (n = 5) and in 11 of 15 brains of rabbits 18 to 24 hours after intracisternal infection with Streptococcus pneumoniae. This suggests a substantial contribution of axonal pathology to neurologic sequelae after bacterial meningitis.

Received May 29, 2003. Accepted in final form October 14, 2003.




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