CT OF THE BRAIN IN TUBERCULOUS MENINGITIS. A review of 289 patients

Özateş, Mustafa; Kemaloğlu, Serdar; Gürkan, Fuat; Özkan, Ümit; Hoşoğlu, Salih; Şimşek, Mahmut

doi:10.1034/j.1600-0455.2000.041001013.x

Cited by 101 publications

(55 citation statements)

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“…Underlying immunogenetic susceptibility to develop strong inflammatory response to MTB might explain the high rate of CI complicating TBM in Chinese. The predominance of anterior circulation CI and relative sparing of posterior circulation arteries were consistent with previous reports [9, 20, 22]. Among 25 children with TBM complicated by CI, 23 had distribution of CI in the anterior circulation, and 2 had CI in the posterior circulation affecting the following arteries: lenticulostriate in 16 patients, MCA in 3 patients, internal carotid artery in 1 patient and multiple sites in 3 patients [19].…”

Section: Discussionsupporting

confidence: 79%

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Cerebral Infarcts Complicating Tuberculous Meningitis

Chan¹,

Cheung²,

Lee

et al. 2005

Cerebrovasc Dis

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Cerebral infarction (CI) is a serious complication of tuberculous meningitis (TBM). It can be asymptomatic or symptomatic, causing stroke. We studied 40 TBM patients. All had initial CT brain scan, CT/MRI brain scan 3 months later and urgent CT brain scan for deterioration. CI was classified into lacunar infarction (LI) or large artery infarction (LAI). Twelve (30%) had CI, in 9 (23%) it was symptomatic and in 3 (8%) silent. Seven (58%) had LAI ± LI. Eight (67%) had multiple CI. Two died from brainstem CI and 6 were dependent at 1 year. Patients with LAI might develop posterior circulation CI more frequently than those with LI only. CI is a common complication of TBM locally, with LAI and multiple CI being common. Two thirds of TBM patients complicated by CI had poor prognosis despite adjunctive dexamethasone treatment.

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Section: Discussionsupporting

confidence: 79%

“…These changes jeopardize arterial blood flow causing ischemia and CI [18,19,20]. Complicating hydrocephalus may stretch blood vessels, further aggravating cerebral ischemia [4, 21, 22]. Nevertheless, there is no evidence that decompressive procedures for hydrocephalus can prevent CI in TBM [23].…”

Section: Discussionmentioning

confidence: 99%

Cerebral Infarcts Complicating Tuberculous Meningitis

Chan¹,

Cheung²,

Lee

et al. 2005

Cerebrovasc Dis

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“…This is consistent with reports of adult TBM in the literature of 34 and 45%, respectively [26,27,28]. …”

Section: Discussionsupporting

confidence: 82%

Adult Tuberculous Meningitis in Qatar: A Descriptive Retrospective Study from its Referral Center

Imam

Ahmedullah²,

Akhtar³

et al. 2014

Eur Neurol

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Background: Tuberculous meningitis is the severest and commonest form of central nervous system tuberculosis causing high mortality and morbidity. We aim to study the clinical, biochemical, and radiological characteristics of tuberculous meningitis in adult patients in Qatar and to calculate the incidence. Methods: A descriptive retrospective 7-year study was conducted at the Hamad General Hospital (the only tertiary referral center and sole health care provider for tuberculosis in Qatar) between the 1st of January 2006 and the 31st of December 2012, to describe the clinical presentation, diagnosis, treatment, outcome, and the incidence of adult tuberculous meningitis in Qatar. Results: Tuberculous meningitis was diagnosed in 80 patients (65 male, 15 female), with a mean age of 30.3 w 8.9. The majority of patients (76.3%) were from the Indian subcontinent. The commonest clinical features were fever (79%), headache (71%), and meningism (56%). Cerebrospinal fluid tuberculosis culture was positive in 44% of patients. Almost 39% of patients were in Stage I, 46% in Stage II and 15% in Stage III of the disease. The commonest neuroimaging features were leptomeningeal enhancement (34%) and hydrocephalus (33%). Cranial nerve palsy, limb weakness, and an elevated C-reactive protein were associated with a poorer outcome. Sixty eight percent had complete recovery, 10% had residual neurological sequelae without disability, 17% had disability, and 5% died. The average incidence of tuberculous meningitis over 7 years was 0.9 per 100,000 adult population. Conclusion: The characteristics of tuberculous meningitis were described in our population. Our data indicate that the incidence of tuberculosis meningitis in Qatar has increased. Tuberculous meningitis in Qatar is mainly an imported disease. i 2014 S. Karger AG, Basel

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“…14,15,16 CT helps in recognising features suggestive of CNS tuberculosis like basal enhancement, tuberculoma and identifying complications of TBM including infarction and hydrocephalus. 8,17,18,19 The common triad of CT findings in TBM are:…”

Section: Discussionmentioning

confidence: 99%