MECHANISMS OF BRAIN INJURY IN BACTERIAL-MENINGITIS - WORKSHOP SUMMARY

Morbidity and mortality associated with bacterial meningitis remain hi gh, although antibiotic therapy has improved during recent decades. Th e major intracranial complications of bacterial meningitis are cerebro vascular arterial and venous involvement, brain edema, and hydrocephal us with a subsequent increase of intracranial pressure. Experiments in animal models and cell culture systems have focused on the pathogenes is and pathophysiology of bacterial meningitis in an attempt to identi fy the bacterial and/or host factors responsible for brain injury duri ng the course of infection. An international workshop entitled ''Bacte rial Meningitis: Mechanisms of Brain Injury'' was organized by the Dep artment of Neurology at the University of Munich and was held in Eibse e, Germany, in June 1993. This conference provided a forum for the exc hange of current information on bacterial meningitis, including data o n the clinical spectrum of complications, the associated morphological alterations, the role of soluble inflammatory mediators (in particula r cytokines) and of leukocyte-endothelial cell interactions in tissue injury, and the molecular mechanisms of neuronal injury, with potentia l mediators such as reactive oxygen species, reactive nitrogen species , and excitatory amino acids. It is hoped that a better understanding of the pathophysiological events that take place during bacterial meni ngitis will lead to the development of new therapeutic regimens.