Clinical relevance of hydrocephalus as a presenting feature of tuberculous meningitis

Abstract

Hydrocephalus upon presentation is common in our TBM patients. This may be a poor prognostic marker associated with severe TBM and a higher risk of stroke.

Neurological and systemic complications of tuberculous meningitis and its treatment at Auckland City Hospital, New Zealand

“…Vasospasm and ventricular dilatation may contribute to constriction of arteries already compromised by vasculitis. 9,13,21 After recovery from the acute illness, fibrosis around blood vessels in the subarachnoid space can cause late-onset infarcts. 8,10 Angiography typically shows focal narrowing of the arteries at the base of the brain, most commonly in the terminal portions of the internal carotid arteries and the proximal segments of the middle and anterior cerebral arteries.…”

“…In some series hydrocephalus has predicted a poor outcome, 12 but surgical drainage does not consistently improve the long-term outcome. 21 Corticosteroids may reduce the number of patients with tuberculous meningitis who develop hydrocephalus. 14 Cranial neuropathies occurred in 29% of our patients and in 20% to 52% of patients with tuberculous meningitis in other series.…”

Clinical and laboratory characteristics of cerebral infarction in tuberculous meningitis: A comparative study

“…1,2,6 Much data relating to the complications of TB meningitis, including tuberculoma, hydrocephalus, encephalomyelopathy, radiculomyelitis, and cranial nerve palsies have been reported. 1,2,[6][7][8][9] Cerebral infarction secondary to infection has also been reported as a complication of TB meningitis. Prevention or reduction of complications, particularly significant complications such as cerebral infarction, is the most challenging goal for providing quality patient care.…”

Frequency of Hydrocephalus in Cases of TBM

“…[8][9][10] However lower percentages were seen in a study conducted by Chan et al who found it in 29% of the cases. 11 Why is this hydrocephalus found higher in our study as compared to the ones with lower percentages, it might be the cut off value used in this study, which was quite on the lower side, that's why it reflected in a very higher number. And the other studies with similar percentages also had lower threshold to label it.…”