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Related Concept Videos

Bacterial Meningitis I: Introduction01:22

Bacterial Meningitis I: Introduction

Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
Hemorrhagic Stroke l: Introduction01:17

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A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Stroke: Introduction and Types01:29

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A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...
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Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
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A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...

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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
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Published on: August 30, 2020

Stroke in tuberculous meningitis.

Usha Kant Misra1, Jayantee Kalita, Pradeep Kumar Maurya

  • 1Department of Neurology, Sanjay Gandhi PGIMS, Lucknow, India. drukmisra@rediffmail.com

Journal of the Neurological Sciences
|January 29, 2011
PubMed
Summary
This summary is machine-generated.

Stroke is common in tuberculous meningitis (TBM), often affecting the basal ganglia due to arterial involvement. Further research is needed on treatments like aspirin to reduce stroke incidence in TBM patients.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Stroke is a frequent complication of tuberculous meningitis (TBM), occurring in 15-57% of patients, particularly those with advanced disease.
  • Strokes in TBM can be asymptomatic and are often multiple, bilateral, and located in the basal ganglia, a region known as the 'tubercular zone'.

Purpose of the Study:

  • To investigate the frequency, location, and potential causes of stroke in patients with tuberculous meningitis.
  • To review the diagnostic utility of MRI and other imaging modalities in detecting stroke in TBM.
  • To explore the role of inflammatory cytokines and prothrombotic states in TBM-related stroke.

Main Methods:

  • Review of existing literature and case studies on stroke in TBM.
  • Analysis of imaging findings, particularly MRI (DWI, T2, FLAIR), angiography, and autopsy results.
  • Examination of pathological mechanisms including arteritis, cytokine involvement (TNFα, VEGF, MMPs), and prothrombotic factors.

Main Results:

  • Most TBM strokes are bilateral, multiple, and located in the basal ganglia ('tubercular zone'), affecting arteries like the medial striate, thalamotuberal, and thalamostriate.
  • Cortical strokes can also occur due to involvement of major cerebral arteries (MCA, ACA, PCA, ICA, basilar).
  • Autopsy studies indicate arteritis is more common than infarction, with cytokines and prothrombotic states implicated in pathogenesis.

Conclusions:

  • Stroke is a significant neurological complication of TBM, with characteristic patterns and locations.
  • While corticosteroids and antitubercular therapy may reduce mortality, their specific impact on stroke reduction in TBM requires further investigation.
  • The role of aspirin in reducing stroke in TBM warrants additional research.