An Unusual Association – Tuberculous Meningitis Causing Cerebral Venous Thrombosis

NATARAJAN, .; George, Suzanne; Eapen, George A.; Arulneyam, Jayanthi

doi:10.17659/01.2015.0088

Cited by 6 publications

(1 citation statement)

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“…There are few case reports of CVST in TBM. [13][14][15] In a large study by Bansod et al, abnormal MRV finding was noted in 12 (11.2%) out of 107 TBM patients. 16 In another study by Kalita et al, there was no evidence of venous thrombosis, although many variations in sinuses such as hypoplastic transverse sinus were seen.…”

Section: Discussionmentioning

confidence: 99%

Vascular Manifestations of Tuberculous Meningitis: MR Angiography and Venography Study

Naik

Bhoi

Deep

et al. 2022

JNRP

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Purpose The purpose of this study is to evaluate magnetic resonance (MR) angiography (MRA) and venography (MRV) findings in tuberculous meningitis (TBM). Methods Thirty consecutive patients of clinically diagnosed TBM were enrolled. Apart from T2-weighted imaging, T1-weighted imaging (T1WI), diffusion-weighted imaging, susceptibility-weighted imaging, fluid-attenuated inversion recovery, and postcontrast T1WI, time-of-flight (TOF) MRA and postcontrast MRV were done in all the patients. MRV was done after intravenous administration of gadolinium-based contrast agent followed by postcontrast T1WI. MRA and MRV findings were analyzed. Results Mean age of the patients was 33.13 ± 14.93 years. Duration of symptom was 34.90 ± 33.82 (range: 10–150) days. Out of 30 patients, 11 were categorized as definite TBM and 19 probable TBM. Eighteen (60%) were grade I, 7 (23%) grade II, and 5 (16%) grade III TBM based on severity. MR abnormalities were in varying combinations of leptomeningeal enhancement in 24 (80%), pachymeningeal in 2, both in 3, tuberculomas in 13 (43.3%), ventriculitis in 1, hydrocephalus in 16 (53.3%), and infarcts in 10 (33.3%) patients out of which the tubercular zone infarct in 9 patients. TOF MRA showed arterial abnormality in 13 patients. Anterior cerebral artery and middle cerebral artery have commonly involved vessels. Dural sinus thrombosis was noted in two patients. Both were female. One patient had subacute thrombus in the posterior part of superior sagittal sinus, left transverse sinus, and proximal right transverse sinus. The second patient had a filling defect in the transverse sinus. Conclusion In TBM, there is predominant arterial involvement causing infarcts which are usually seen in the tubercular zone. However, occasionally, there may be venous involvement causing cerebral venous sinus thrombosis.

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Section: Discussionmentioning

confidence: 99%