{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:24:40Z","timestamp":1787837080566,"version":"build-2784847793"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>Despite dramatic improvements in diagnosis and antimicrobial treatment of bacterial meningitis over the last few decades, adverse postinfective sequelae and mortality remain exceedingly high in adults. Of note, the unfavorable clinical outcome is usually attributable to the presence of intracranial complications during the acute phase of infection, such as cerebral edema and increases in intracranial pressure and cerebral blood flow disturbances. Involvement of the cerebral vasculature during bacterial meningitis is overwhelmingly clear from clinical and laboratory evidence highlighting cerebral blood flow alterations with the use of Doppler blood flow analysis, angiographic studies of cerebral vessel wall structural irregularities and computed tomography\/magnetic resonance imaging recording of cerebral infarctions. With the widespread agreement of cerebrovascular involvement in bacterial meningitis, very few studies have documented histopathological observations of cerebral vessel irregularities affecting the various layers of the vascular wall. In an attempt to understand the arterial wall changes that take place before the occurrence of cerebral ischemic consequences in bacterial meningitis, we have investigated the sequential changes affecting the arterial vasculature, beginning with early reflexive modifications of the adventitia and culminating in late proliferative lesions of the intima.<\/jats:p>","DOI":"10.4103\/bc.bc_4_23","type":"journal-article","created":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T17:00:10Z","timestamp":1748710810000},"page":"97-106","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Cerebral arteritis in bacterial meningitis: Structural adaptations of the vascular wall in response to an infectious nidus \u2013 A narrative review"],"prefix":"10.4103","volume":"11","author":[{"given":"Vivig Shantha","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, California, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vignarth Shantha","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, California, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,5,31]]},"reference":[{"key":"R1-20260422","first-page":"282.","article-title":"Ueber die ver\u00e4nderungen des gehirns und r\u00fcckenmarks bei meningitis cerebrospinalis","volume":"47","author":"Loewenstein","year":"1910","journal-title":"Beitr Path Anat Allg Path"},{"key":"R4-20260422","doi-asserted-by":"crossref","first-page":"549.","DOI":"10.1001\/archneurpsyc.1931.02230090082006","article-title":"The cerebral lesions in purulent meningitis","volume":"26","author":"Wertham","year":"1931","journal-title":"Arch Neurol Psychiatry"},{"key":"R7-20260422","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1136\/bmj.1.2524.1170","article-title":"A case of tuberculous meningitis without tubercles","volume":"1","author":"Higgs","year":"1909","journal-title":"Br Med J"},{"key":"R8-20260422","doi-asserted-by":"crossref","first-page":"401.","DOI":"10.1007\/BF02880283","article-title":"Gefassbedingte herde bei der tuberkulosen meningitis","volume":"125","author":"Bodechtel","year":"1930","journal-title":"Ztschr Ges Neurol Psychiat"},{"key":"R9-20260422","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1542\/peds.38.1.6","article-title":"Neonatal meningitis. A clinical and pathological study of 29 cases","volume":"38","author":"Berman","year":"1966","journal-title":"Pediatrics"},{"key":"R10-20260422","first-page":"88","article-title":"Vascular changes in meningitis and their importance for the pathogenesis of early brain damage","volume":"314","author":"Eicke","year":"1947","journal-title":"Virchows Arch Pathol Anat Physiol Klin Med"},{"key":"R11-20260422","first-page":"5","article-title":"Pathogenesis of tubercular meningitis","volume":"52","author":"Rich","year":"1933","journal-title":"Bull John Hopkins Hosp"},{"key":"R12-20260422","article-title":"Typical Case of Tubercular Meningitis","author":"Danforth","year":"1878","journal-title":"American Quarterly Microscop Journal"},{"key":"R13-20260422","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1097\/00000658-193501000-00039","article-title":"Pathology of acute purulent meningitis","volume":"101","author":"Winkelman","year":"1935","journal-title":"Ann Surg"},{"key":"R14-20260422","doi-asserted-by":"crossref","first-page":"13.","DOI":"10.1001\/jama.1906.62510280013001c","article-title":"A study of brain infections with the pneumococcus","volume":"46","author":"Southard","year":"1906","journal-title":"JAMA"},{"key":"R16-20260422","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1084\/jem.1.1.112","article-title":"The vascular changes of tuberculous meningitis, especially the tuberculous endarterities","volume":"1","author":"Hektoen","year":"1896","journal-title":"J Exp Med"},{"key":"R17-20260422","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1001\/archneur.1962.00450230052007","article-title":"An electron-microscopic study of bacterial meningitis. I. Experimental alterations in the leptomeninges and subarachnoid space","volume":"6","author":"Nelson","year":"1962","journal-title":"Arch Neurol"},{"key":"R18-20260422","first-page":"546","article-title":"Three phases of cerebral arteriopathy in meningitis: Vasospasm and vasodilatation followed by organic stenosis","volume":"16","author":"Yamashima","year":"1985","journal-title":"Neurosurgery"},{"key":"R19-20260422","doi-asserted-by":"crossref","first-page":"789.","DOI":"10.1001\/archneurpsyc.1932.02240040034003","article-title":"Histologic studies in meningitis","volume":"28","author":"Hassin","year":"1932","journal-title":"Arch Neurol Psychiatry"},{"key":"R20-20260422","first-page":"134","article-title":"Pathology of cerebral vasculature in neurotuberculosis e some observations","volume":"14","author":"Shankar","year":"2001","journal-title":"Prog Clin Neurosci"},{"key":"R21-20260422","first-page":"vii","article-title":"Note istologiehe sulla mening. tuberculate","year":"1883","journal-title":"Arch per le scien med"},{"key":"R22-20260422","first-page":"26","article-title":"Tuberculous meningitis (a clinico-pathological study)","volume":"25","author":"Thomas","year":"1977","journal-title":"Neurol India"},{"key":"R24-20260422","first-page":"171","article-title":"The effect of streptomycin upon the pathology of tuberculous meningitis","volume":"61","author":"Winter","year":"1950","journal-title":"Am Rev Tuberc"},{"key":"R25-20260422","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1002\/path.1700580407","article-title":"Cerebral arteritis and phlebitis in pneumococcal meningitis","volume":"58","author":"Cairns","year":"1946","journal-title":"J Pathol Bacteriol"},{"key":"R26-20260422","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1136\/jnnp.20.4.250","article-title":"The late sequelae of pneumococcal meningitis","volume":"20","author":"Smith","year":"1957","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R27-20260422","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1007\/s00401-008-0416-9","article-title":"Fibrinoid necrosis of small brain arteries and arterioles and miliary aneurysms as causes of hypertensive hemorrhage: A critical reappraisal","volume":"116","author":"Rosenblum","year":"2008","journal-title":"Acta Neuropathol"},{"key":"R28-20260422","first-page":"33353.","article-title":"Die gefassveranderungbei der akuten tuberkulosen meningitis und ihre beziehungen zu gehirnl\u00e4sionen","volume":"99","author":"Askanazy","year":"1910","journal-title":"Dtsch Arch Klin Med"},{"key":"R29-20260422","first-page":"315","article-title":"Meningeal blood vessels in tuberculous meningitis","volume":"42","author":"Winkleman","year":"1940","journal-title":"Am Rev Tuberc"},{"key":"R30-20260422","first-page":"351","article-title":"The many facets of neurotuberculosis: An epitome of neuropathology","volume":"2","author":"Dastur","year":"1973","journal-title":"Prog Neuropathol"},{"key":"R31-20260422","first-page":"5.","article-title":"Zur pathologie \u00f6rtliche elektiven gehirnver\u00e4nderungen","volume":"99","author":"Spielmeyer","year":"1925","journal-title":"Ztschr Neurol Psychiat"},{"key":"R32-20260422","first-page":"111","article-title":"In: Neurosurgical Applications of Transcranial Doppler Sonography","author":"Harders","year":"1986","journal-title":"Essay, Springer Viena,"},{"key":"R33-20260422","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1097\/00000441-191602000-00009","article-title":"The occurrence of arteritis in meningitis","volume":"151","author":"McMeans","year":"1916","journal-title":"Am J Med Sci"},{"key":"R34-20260422","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1016\/S0025-7125(16)31420-1","article-title":"Tuberculous meningitis","volume":"66","author":"Meyers","year":"1982","journal-title":"Med Clin North Am"},{"key":"R35-20260422","doi-asserted-by":"crossref","first-page":"26.","DOI":"10.1186\/s40478-016-0297-4","article-title":"Pneumococcal meningitis: Clinical-pathological correlations (MeninGene-Path)","volume":"4","author":"Engelen-Lee","year":"2016","journal-title":"Acta Neuropathol Commun"},{"key":"R36-20260422","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1542\/peds.52.4.586","article-title":"Bacterial meningitis. A symposium","volume":"52","author":"Smith","year":"1973","journal-title":"Pediatrics"},{"key":"R37-20260422","first-page":"313","article-title":"Contribution a\u2019 l\u2019e\u2019tude de la tuberculose","volume":"xvi","journal-title":"Journal de l\u2019anat et de laphys"},{"key":"R39-20260422","first-page":"133","article-title":"Gross cerebral hemorrhage and vascular lesions in acute tuberculous meningitis and meningo-encephalitis","volume":"23","author":"Goldzieher","year":"1947","journal-title":"Am J Pathol"},{"key":"R40-20260422","first-page":"616","article-title":"The effects of streptomycin on the gross and histological picture of tuberculous meningitis","volume":"29","author":"Terplan","year":"1953","journal-title":"Am J Pathol"},{"key":"R41-20260422","first-page":"571","article-title":"Der miliare tuberkel","volume":"xxiv","year":"1862","journal-title":"Virchows Arch"},{"key":"R42-20260422","first-page":"807.","article-title":"Etude histologique de l\u2019\u00e9corce c\u00e9r\u00e9brale dans dixhuit cas de m\u00e9ningite","volume":"10","author":"Faure","year":"1902","journal-title":"Rev Neurol"},{"key":"R43-20260422","first-page":"258","article-title":"Pathogenese de ~ herdsymptome bei tuberc","volume":"xxvi","year":"1894","journal-title":"Meningitis Zeitsch Medicin"}],"container-title":["Brain Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/bc.bc_4_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:15:05Z","timestamp":1787836505000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/bc.bc_4_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":36,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/bc.bc_4_23","relation":{},"ISSN":["2394-8108","2455-4626"],"issn-type":[{"value":"2394-8108","type":"print"},{"value":"2455-4626","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2023-01-17","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-07","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}