Ultrasound diagnosis of multiple cystic encephalomalacia.

Following bacterial meningitis thirty cases of enlarging head were evaluated on ultrasound to find out the cause. Nine out of 30 patients had multiple cystic lesions in both cerebral hemispheres with or without ventriculomegaly. Three patients showed debris in the cysts suggesting pus, which was confirmed on ultrasound-guided aspiration in two and on surgery in one case. Seven out of nine patients had died at the time of writing this communication, suggesting the need for its early detection and timely family counselling. It is stressed that multiple cystic encephalomalacia has a characteristic appearance on ultrasound and all patients with meningitis should be screened routinely so as to detect it at an early stage.