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Updated: Oct 21, 2025
A Volumetric Method for Quantification of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage
Published on: July 28, 2018
Evaluation of intracranial vasculitis in tuberculous meningitis using magnetic resonance vessel wall imaging
Harshad Arvind Vanjare1, Karthik Gunasekaran2, Abi Manesh3
1Department of Radiology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
Background:
Tuberculous meningitis (TBM) is a global health problem with important complications such as acute infarcts secondary to vasculitis contributing to adverse outcomes. The objective of this study is to assess intracranial vasculitis in patients with TBM, either during their initial diagnosis or during follow-up while on standard antituberculous therapy.
Methods:
Ten patients with TBM underwent magnetic resonance (MR) based vessel wall imaging (VWI) to identify intracranial vasculitis (five patients during their initial presentation and the other five patients during their follow-up visit).
Results:
Vasculitis was seen in 60% of the patients wherein 70% of their intracranial vessels were affected. Acute and chronic infarcts were seen in four and two patients respectively, one of whom had both acute and chronic infarcts. Leptomeningeal enhancement and basal cisternal tuberculomas were frequently seen in patients with vasculitis. Vasculitis was also seen many days after the commencement of the antituberculous therapy thus explaining late-onset infarcts in this disease.
Conclusion:
Intracranial vasculitis is common in the patient with TBM. MR-based VWI technique has the potential for infarct risk assessment and to help guide the treatment for its possible prevention.
Insights
Intracranial vasculitis is common in tuberculous meningitis (TBM). Magnetic resonance vessel wall imaging can assess infarct risk and guide treatment to prevent complications in TBM patients.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Tuberculous meningitis (TBM) is a significant global health concern.
- Vasculitis-induced infarcts are a major complication of TBM, leading to poor outcomes.
- Assessing intracranial vasculitis is crucial for managing TBM.
Purpose of the Study:
- To evaluate the prevalence and characteristics of intracranial vasculitis in TBM patients.
- To assess vasculitis at initial diagnosis and during follow-up under antituberculous therapy.
- To explore the relationship between vasculitis, infarcts, and treatment in TBM.
Main Methods:
- Employed magnetic resonance (MR)-based vessel wall imaging (VWI).
- Studied ten TBM patients (five at initial diagnosis, five during follow-up).
- Assessed intracranial vessels for signs of vasculitis.
Main Results:
- Intracranial vasculitis detected in 60% of TBM patients.
- An average of 70% of intracranial vessels were affected by vasculitis.
- Infarcts (acute and chronic) were observed in several patients; vasculitis persisted even after therapy initiation, explaining late-onset infarcts.
Conclusions:
- Intracranial vasculitis is a frequent finding in TBM.
- MR-based VWI is a valuable tool for assessing infarct risk in TBM.
- VWI can aid in guiding treatment strategies for infarct prevention in TBM.
