Related Experiment Videos
Locations of cerebral infarctions in tuberculous meningitis
F Y Hsieh1, L G Chia, W C Shen
1Section of Neurology, Taichung Veterans General Hospital, Taiwan, Republic of China.
Abstract:
The locations of cerebral infarctions were studied in 14 patients with tuberculous meningitis (TBM) and 173 patients with noninflammatory ischemic stroke (IS). In patients with TBM, 75% of infarctions occurred in the "TB zone" supplied by medial striate and thalamoperforating arteries; only 11% occurred in the "IS zone" supplied by lateral striate, anterior choroidal and thalamogeniculate arteries. In patients with IS, 29% of infarctions occurred in the IS zone, 29% in the subcortical white matter, and 24% in (or involving) the cerebral cortex. Only 11% occurred in the TB zone. Bilaterally symmetrical infarctions of the TB zone were common with TBM (71%) but rare with IS (5%).
Insights
Tuberculous meningitis (TBM) causes unique brain infarction patterns, primarily affecting the "TB zone" supplied by specific arteries. Noninflammatory ischemic stroke (IS) shows different infarction locations, rarely involving the TB zone.
Area of Science:
- Neurology
- Neuroimaging
- Infectious Diseases
Background:
- Cerebral infarctions can result from various causes, including inflammation and noninflammatory ischemic events.
- Tuberculous meningitis (TBM) is an infectious disease that can lead to neurological complications, including stroke.
- Understanding the specific patterns of cerebral infarction in TBM is crucial for diagnosis and management.
Purpose of the Study:
- To compare the anatomical locations of cerebral infarctions in patients with tuberculous meningitis (TBM) and noninflammatory ischemic stroke (IS).
- To identify characteristic infarction patterns associated with TBM versus IS.
Main Methods:
- Retrospective analysis of neuroimaging findings in 14 patients with TBM and 173 patients with IS.
- Categorization of infarction locations into the "TB zone" (supplied by medial striate and thalamoperforating arteries) and the "IS zone" (supplied by lateral striate, anterior choroidal, and thalamogeniculate arteries).
Main Results:
- In TBM patients, 75% of infarctions occurred in the TB zone, compared to only 11% in IS patients.
- IS patients predominantly had infarctions in the IS zone (29%), subcortical white matter (29%), and cerebral cortex (24%).
- Bilaterally symmetrical infarctions in the TB zone were significantly more common in TBM (71%) than in IS (5%).
Conclusions:
- Cerebral infarction patterns differ significantly between TBM and noninflammatory IS.
- The "TB zone" is a characteristic location for infarctions in TBM, often presenting bilaterally and symmetrically.
- Neuroimaging can help differentiate stroke etiologies, aiding in the diagnosis of TBM.