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Case of Subarachnoid Hemorrhage Caused by Tuberculous Aneurysm

Wei Liu1, Chuanfeng Li2, Xianming Liu2

  • 1Department of Neurosurgery, Affiliated Hospital of Qingdao University, Qingdao, China.

World Neurosurgery
|November 4, 2017
PubMed
Abstract

Insights

Ruptured tuberculosis-associated aneurysms are rare. This case highlights an intracranial tuberculum with an adjacent inflammatory aneurysm causing subarachnoid hemorrhage and brain abscess.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Tuberculosis can affect the central nervous system, leading to complications like tuberculomas and meningitis.
  • Tuberculous meningitis can cause vasculitis, potentially resulting in aneurysms, though this is rare.

Observation:

  • A 28-year-old man with a history of pulmonary tuberculosis presented with subarachnoid hemorrhage.
  • Initial imaging revealed a hematoma, but no aneurysm was detected.
  • Follow-up imaging showed a brain abscess, and surgery revealed an associated middle cerebral artery aneurysm.

Findings:

  • The case describes a rare instance of an intracranial infectious aneurysm linked to tuberculosis.
  • The aneurysm was associated with a brain abscess and caused subarachnoid hemorrhage.
  • The aneurysm was suspected to be inflammatory due to its association with tuberculosis.

Implications:

  • This case underscores the importance of considering tuberculosis as a potential cause of intracranial aneurysms, even in the absence of meningitis.
  • Early diagnosis and treatment of CNS tuberculosis are crucial to prevent rare but severe vascular complications.
  • Management involves addressing both the infectious and vascular components, including abscess drainage and aneurysm repair.
Keywords:
AneurysmSubarachnoid hemorrhageTuberculosis

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