Related Experiment Video
Updated: Jul 2, 2026
Advanced Diffusion Imaging in The Hippocampus of Rats with Mild Traumatic Brain Injury
Published on: August 14, 2019
Evaluation of cerebral infarction in tuberculous meningitis by diffusion weighted imaging
Rakesh Shukla1, Asad Abbas, Praveen Kumar
1Department of Neurology, Chhatrapati Shahuji Maharaj Medical University (Erstwhile King George's Medical University), Lucknow 226003, Uttar Pradesh, India. rakeshshukla_rakesh@rediffmail.com
Background:
Ischemic complications are known to occur in tuberculous meningitis (TBM). They are usually seen in patients with TBM having a more severe disease. Diffusion weighted imaging (DWI) provides information regarding tissue ischemia at an early stage as compared to conventional magnetic resonance imaging (MRI).
Methods:
Ischemic complications in human immunodeficiency virus (HIV) negative TBM were evaluated using DWI and T2 weighted imaging in 30 patients in the present study. The imaging was performed at baseline within 7 days of admission and in case of any neurological deterioration during follow up. The outcome was assessed by the modified Barthel's index at 1 year follow up. A score of >/=12 was taken as a poor outcome, while a score of <12 was considered as good outcome.
Result:
Seventeen of these 30 patients had infarcts, and the total number of infarcts seen was 42. Thirty eight lesions were acute/sub acute and four were chronic infarcts. Out of the 38 acute/sub acute infarcts 34 were visible both on T2 weighted imaging and on DWI, while four were seen only on DWI. The volume of infarcts as seen by DWI was significantly larger as compared to conventional T2 weighted imaging (p = 0.019). Six patients had a poor outcome, five from the infarct group and one from the non-infarct group.
Conclusion:
DWI demonstrates a larger area of infarction and may also be useful in the early detection of infarction. It should be used as an additional sequence along with conventional imaging in patients with TBM while they are on a follow up on anti tuberculous treatment. The information obtained by DWI may be of value in explaining the clinical condition of the patient as well as in the management and prognostication.
Insights
Diffusion weighted imaging (DWI) detects more extensive infarcts in tuberculous meningitis (TBM) than conventional MRI. This advanced imaging technique aids in early diagnosis and prognosis of TBM complications.
Area of Science:
- Neurology
- Radiology
- Infectious Diseases
Background:
- Tuberculous meningitis (TBM) can lead to ischemic complications, often associated with severe disease.
- Diffusion weighted imaging (DWI) offers earlier detection of tissue ischemia compared to conventional MRI.
Observation:
- This study evaluated ischemic complications in 30 HIV-negative TBM patients using DWI and T2-weighted imaging.
- Imaging was performed at baseline and during follow-up for neurological changes.
- Patient outcomes were assessed at 1 year using the modified Barthel's index.
Findings:
- Seventeen patients (57%) exhibited 42 infarcts, with 38 being acute/subacute.
- DWI identified infarcts with significantly larger volumes than T2-weighted imaging (p=0.019).
- Four acute/subacute infarcts were detected exclusively by DWI.
Implications:
- DWI reveals a greater extent of infarction and aids in early detection of ischemic complications in TBM.
- Integrating DWI with conventional imaging is valuable for monitoring TBM patients.
- DWI findings can inform clinical management and patient prognostication.
Related Concept Videos
01:17Assessment of Diffusion and Perfusion
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this principle...
01:26Pulmonary Tuberculosis IV
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...