Evaluation of cerebral infarction in tuberculous meningitis by diffusion weighted imaging

Shukla, Rakesh; Abbas, Asad; Kumar, Praveen; Gupta, Rakesh K.; Jha, Sanjeev; Prasad, Kashi Nath

doi:10.1016/j.jinf.2008.07.012

Cited by 49 publications

(39 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most commonly affected are the basal ganglia, predominantly the anterior part, whereas ischemic stroke occurs more frequently in the posterior region [19,20,25,[26][27][28]. Infarction may be asymptomatic, but can also cause severe disability and death, and is associated with poor outcome [19,29].…”

Section: Imagingmentioning

confidence: 99%

Tuberculous Meningitis in Adults: A Review of a Decade of Developments Focusing on Prognostic Factors for Outcome

2012

View full text Add to dashboard Cite

Tuberculous meningitis (TBM) is the most severe form of TB. Despite treatment, mortality and long-term disability remain unacceptably high. Prevention, early recognition, diagnosis and treatment are fundamental to improving outcomes. However, an effective vaccine remains elusive, initial symptoms are nonspecific, and sensitive diagnostic tests are not available. There has been progress in our understanding of the immunopathology of TBM, and several factors have been found to be associated with susceptibility to infection, disease progression and clinical outcome. However, these have not yet impacted on treatment. Early treatment initiation and uninterrupted continuation, severity on presentation, seizures, stroke, cranial nerve involvement, cerebrospinal fluid cell count and lactate levels, hyponatreamia and coinfection with HIV are all found to be important prognostic factors for outcome. Pathogen lineage (Beijing genotype) and host genetics (polymorphisms in TLR2, TIRAP and LTA4H genes) can influence susceptibility to TBM. However, these findings have not yet impacted on treatment. Progress in vaccine development, opportunities for better diagnostic tests, novel insights into pathogenesis and an increasing evidence base for improving treatment should impact the current high mortality and morbidity, if translated to global and local guidelines.

show abstract

Section: Imagingmentioning

confidence: 99%

Tuberculous Meningitis in Adults: A Review of a Decade of Developments Focusing on Prognostic Factors for Outcome

2012

View full text Add to dashboard Cite

show abstract

“…However diffuse intra cerebral intravascular coagulopathy could also be another cause of infarct apart from vasculitis [3]. Similar findings are also observed in severe cases of tuberculous meningitis where diffusion abnormalities appears earlier than conventional imaging [4]. Pneumococcal meningitis can mimic tubercular meningitis on imaging with exudates and acute infarcts however clinical and historical correlation will help.…”

Section: Sirmentioning

confidence: 66%

Meningitis with Infarcts Is it Always Tubercular?

Kamble¹

2015

CSMC

View full text Add to dashboard Cite

“…The middle cerebral and lenticulostriate arteries are most commonly affected [Dastur et al 1970, Trivedi et al 2009]. Diffusion-weighted MR imaging helps in the early detection of this complication [Shukla et al 2008, Trivedi et al 2009]. …”

Section: Neuroradiological Findings In Vasculitismentioning

confidence: 99%

Neuro-radiology: a new gold standard investigation for management of central nervous system tuberculosis

Gautam

2016

IJM

View full text Add to dashboard Cite

Treatment of CNS TB is challenging due to lack of specific biochemical tests and inability to get the pathological sample from deeply located eloquent areas of CNS without causing any neurological deficit. Moreover, it is unnecessary to operate for biopsy in a patient who has presented with a very small granulomatious lesion in brain or spinal cord. In such as situations neuro-radiology helps in managing CNS TB and it may be the only source of establishing diagnosis and evaluating treatment response. Role of radiological investigation has expanded from the initial diagnosis to the therapeutic interventions. In some Muli-drug-resistant (MDR) CNS TB cases, Stereotaxy or USG or CT guided biopsy helps in obtaining pathological sample and drug sensitivity testing. A regular clinical and neuro-radiological follow-up is mandatory during the entire course of anti tuberculous therapy to take prompt decisions to change ATT and to reduce morbidity and mortality associated with CNS TB.

show abstract

Evaluation of cerebral infarction in tuberculous meningitis by diffusion weighted imaging

Cited by 49 publications

References 27 publications

Tuberculous Meningitis in Adults: A Review of a Decade of Developments Focusing on Prognostic Factors for Outcome

Tuberculous Meningitis in Adults: A Review of a Decade of Developments Focusing on Prognostic Factors for Outcome

Meningitis with Infarcts Is it Always Tubercular?

Neuro-radiology: a new gold standard investigation for management of central nervous system tuberculosis

Contact Info

Product

Resources

About