{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T11:40:03Z","timestamp":1784720403470,"version":"3.55.0"},"reference-count":27,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T00:00:00Z","timestamp":1629763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T00:00:00Z","timestamp":1629763200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cerebrovasc Dis"],"published-print":{"date-parts":[[2022]]},"abstract":"<b><i>Introduction:<\/i><\/b> Subarachnoid hemorrhage (SAH) has been described as an uncommon complication of community-acquired bacterial meningitis. However, the incidence, clinical course, and outcome are unclear. <b><i>Methods:<\/i><\/b> We assessed the clinical characteristics, incidence, and clinical outcome of patients with SAH complicating bacterial meningitis in a prospective nationwide cohort study from 2006 to 2018 in the Netherlands. Patients were identified through the Netherlands Reference Laboratory for Bacterial Meningitis, which receives around 90% of CSF isolates of all Dutch patients with bacterial meningitis, or after direct report by the treating physician. <b><i>Results:<\/i><\/b> SAH was diagnosed in 22 of 2,306 episodes (0.9%), of which 7 (32%) were diagnosed upon admission and 15 (68%) during admission. All patients showed clinical deterioration before SAH was diagnosed: altered mental status in 18 of 22 patients (82%), focal neurological symptoms in 2 (9%) and, new-onset fever with severe tachycardia in 1 (5%). Acute onset of headache was not reported in any of the patients. Distribution of blood was diffuse in the subarachnoid space in 7 patients (32%), multifocal in 8 patients (36%), and focal in 7 patients (32%) of 22 patients. In 6 patients (27%), CT angiography, MR angiography, or digital subtraction angiography was performed, showing a mycotic aneurysm in 1 patient (5%) and vasculitis in 1 patient (5%). Presence of SAH in bacterial meningitis patients was associated with a poor prognosis assessed at discharge: 12 of 22 patients with SAH died (54%) compared to 361 of 2,257 (16%, <i>p<\/i> &#x3c; 0.001) without SAH, and 19 of 22 had an unfavorable outcome (86%) compared to 831 of 2,257 (37%, <i>p<\/i> &#x3c; 0.001). <b><i>Conclusion:<\/i><\/b> SAH is an uncommon complication in bacterial meningitis and is associated with high case fatality and morbidity. <\/jats:p>","DOI":"10.1159\/000518089","type":"journal-article","created":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T21:00:50Z","timestamp":1629838850000},"page":"118-124","source":"Crossref","is-referenced-by-count":14,"title":["Subarachnoid Hemorrhage in Bacterial Meningitis Patients"],"prefix":"10.1159","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6402-6598","authenticated-orcid":false,"given":"Shahrzad S.","family":"Deliran","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthijs C.","family":"Brouwer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diederik","family":"van de Beek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2021,8,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)00430-2"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.74"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.42.8.1497"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(05)70288-X"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0045271"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1212\/con.0000000000000679"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2007.01.044"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000335247.86599.6f"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-200106000-00001"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/s1042-3680(18)30646-6"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60153-6"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/s0379-0738(03)00133-6"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1186\/s40478-016-0297-4"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awg113"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1989.03430190084036"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1148\/112.1.73"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1148\/123.2.335"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(76)92215-7"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1993.00540060015010"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004405.pub5"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2016.01.007"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-018-0368-8"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.surneu.2006.01.021"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-009-0233-1"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1385\/NCC:4:3:237"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-010-9387-5"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-012-2792-9"}],"container-title":["Cerebrovascular Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/518089","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/518089","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:11:13Z","timestamp":1745421073000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000518089"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,24]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,2,1]]},"published-print":{"date-parts":[[2022,2,8]]}},"URL":"https:\/\/doi.org\/10.1159\/000518089","archive":["Portico"],"relation":{},"ISSN":["1015-9770","1421-9786"],"issn-type":[{"value":"1015-9770","type":"print"},{"value":"1421-9786","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,24]]}}}