本文将重点评论与以实验和临床研究为基础的细菌性脑膜炎有关的中枢神经系统改变的病理生理学和讨论已经使用的或为了预防及转变这些过程的支持疗法。中枢神经系统的主要障碍,是因脑膜炎所导致的颅内压增高,颅内压增高的病理生理改变仍不完全明了,可能有多种因素。脑水肿是导致颅内压增高的主要原因。另一个主要原因为C.S.F吸收异常,可发生间质性脑水肿。颅内压增高的重要后果是脑血流改变。脑膜炎球菌感染时每个半球的平均脑血流正常,而肺炎球菌感染则减少30～40%。其次,颅内压明显增高导致脑灌注压(平均动脉压减颅内压)降低。所以脑因 This article will focus on the pathophysiology of central nervous system changes associated with bacterial meningitis based on experimental and clinical research and to discuss supportive therapies that have been used or in order to prevent and transform these processes. The main obstacle in the central nervous system is the increase of intracranial pressure caused by meningitis. The pathophysiological changes of increased intracranial pressure are still not completely understood. There may be many factors. Brain edema is the leading cause of increased intracranial pressure. Another main reason for abnormal C.S.F absorption, interstitial cerebral edema can occur. An important consequence of increased intracranial pressure is cerebral blood flow changes. The average cerebral blood flow in each hemisphere was normal with meningococcal infection, while pneumococcal infection was reduced by 30-40%. Second, significantly increased intracranial pressure leads to decreased cerebral perfusion pressure (mean arterial pressure minus intracranial pressure). So brain cause