[Influence of intravascular coagulation on brain injury and clinical course in purulent meningitis].

Purulent meningitis (PM), depending on etiology, is associated by up to 30-40 % risk of severe neurological complications and death. Neuronal death occurs frequently as a result of toxin-induced apoptosis and hypoxia. Hypoxia is the result of cerebral edema and hypoperfusion. The former being the reason for, the later the result of elevation of intracranial pressure. Hypoperfusion additionally results from loss of autoregulation of cerebral perfusion and disseminated intravascular coagulation (DIC), causing thrombosis. Spare works in human-beings announce a frequency of DIC of ca 40% in PM. The influence of DIC on prognosis remains unsatisfactory explained. Uncommon are also reports on use of anticoagulants, most often heparins, in PM, but they indicate a possible benefit. It is necessary to conduct epidemiological studies evaluating and staging DIC in patients with PM as well as multivariate analysis to determine its influence on outcome. Drugs of anticoagulant action should be considered for improvement the efficacy of supportive therapy, because this could be of benefit for outcome in PM.