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Acute Stroke in Tubercular Meningitis: A Case Report.
Suzit Bhusal1, Sujata Dahal1, Neha Gautam1
1Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal.
JNMA; Journal of the Nepal Medical Association
|April 25, 2020
Summary
Tubercular meningitis often causes strokes in the basal ganglia due to inflamed arteries. This case highlights vasculitis as a stroke mechanism in meningeal tuberculosis, leading to ischemic infarct and hydrocephalus.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Tubercular meningitis (TM) frequently leads to cerebrovascular complications, particularly strokes.
- Strokes in TM are typically multiple, bilateral, and affect the basal ganglia, specifically the 'tubercular zone'.
- Arterial involvement in exudates and hydrocephalus-induced stretching are proposed mechanisms for stroke in TM.
Observation:
- A 22-year-old female presented with tubercular meningitis.
- The patient experienced ischemic infarct and severe communicating hydrocephalus.
- Seizure disorder was also a noted complication.
Findings:
- The stroke in this case was attributed to vasculitis.
- This case underscores vasculitis as a specific mechanism of stroke in meningeal tuberculosis.
- The patient's presentation included ischemic infarct, hydrocephalus, and seizures.
Implications:
- Understanding the specific mechanisms of stroke, such as vasculitis, is crucial for managing tubercular meningitis.
- Further research is needed to clarify the role of corticosteroids in preventing strokes in TM.
- This case highlights the complex neurological sequelae of tubercular meningitis, including stroke, hydrocephalus, and seizures.
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