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A rare presentation of cerebral venous sinus thrombosis associated with tubercular meningitis

Rajesh Verma1, Rakesh Lalla, Tushar B Patil

  • 1Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India. drrajeshverma32@yahoo.com

BMJ Case Reports
|August 7, 2013
PubMed

Insights

Central nervous system tuberculosis can lead to cerebral venous sinus thrombosis. Early recognition of worsening symptoms like headache or seizures in CNS infection patients is key for timely diagnosis and treatment of this complication.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Nephrology

Background:

  • Central nervous system (CNS) tuberculosis presents with diverse neurological manifestations, including meningitis, meningoencephalitis, tuberculoma, abscess, stroke, and encephalopathy.
  • Tubercular meningitis (TBM) is a recognized, though less common, cause of CNS tuberculosis.
  • Cerebral venous sinus thrombosis (CVST) is a serious vascular complication that can arise in the context of CNS infections.

Observation:

  • This case report details a young male patient who developed CVST.
  • The CVST occurred as a complication subsequent to diagnosed TBM.
  • The patient presented with a worsening of pre-existing headache, impaired consciousness, and seizures.

Findings:

  • The study highlights a direct association between TBM and the subsequent development of CVST.
  • The clinical presentation of worsening headache, altered consciousness, and seizures in a patient with CNS infection should prompt investigation for CVST.
  • This case underscores the potential for TBM to precipitate cerebral venous sinus thrombosis.

Implications:

  • Clinicians managing patients with CNS infections, particularly TBM, should maintain a high index of suspicion for CVST.
  • Prompt diagnosis of CVST in the context of TBM is crucial for initiating appropriate management.
  • Early and effective clinical intervention in CVST secondary to TBM can significantly improve patient outcomes and prognosis.

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