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Irreversible blindness due to multiple tuberculomas in the suprasellar cistern
Kumudini Sharma1, Sunil Pradhan, Atul Varma
1Department of Neurosurgery, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow (U.P.) 226014, India. kumud@sgpgi.ac.in
Summary
A 14-year-old girl experienced sudden blindness due to tuberculous meningitis. Standard treatment failed to restore vision, highlighting the severity of this rare neurological complication.
Area of Science:
- Neuroscience
- Infectious Diseases
- Ophthalmology
Background:
- Tuberculous meningitis (TBM) can present with varied neurological symptoms.
- Ocular involvement in TBM is uncommon but can lead to severe visual impairment.
Observation:
- A 14-year-old girl presented with acute onset fever, headache, vomiting, and bilateral blindness.
- Neuro-ophthalmologic exam revealed meningismus and blindness; brain imaging showed ventriculomegaly and enhancing nodules near the optic chiasm.
Findings:
- Cerebrospinal fluid analysis confirmed Mycobacterium tuberculosis infection via PCR and antibody tests.
- The patient had no other signs of disseminated tuberculosis.
Implications:
- This case underscores the potential for TBM to cause rapid and irreversible vision loss.
- Early diagnosis and aggressive treatment strategies are crucial for managing TBM with ocular complications.