Bedside Transcranial Doppler as a Dynamic Warning Tool for Rapidly Evolving Intracranial Hypertension in Pneumococcal Meningitis

ABSTRACT In severe bacterial meningitis, an initially non‐critical or technically unreliable lumbar puncture opening pressure should not reassure when hydrocephalus and coma persist. Bedside transcranial Doppler cannot measure intracranial pressure, but bilateral near‐absent diastolic flow may provide an urgent warning signal prompting repeat assessment and cerebrospinal fluid diversion.