Cerebral venous thrombosis (CVT) complicating tubercular meningitis

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Qian Li1,2, Junfeng Han3, Yiyi Wang4

  • 1Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, China.

BMC Neurology
|June 24, 2023
PubMed
Abstract

Insights

Cerebral venous thrombosis (CVT) is a rare complication of tuberculous meningitis (TBM). Early diagnosis and treatment of TBM with CVT can improve patient outcomes, with most patients achieving functional independence.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Tuberculous meningitis (TBM) complicated by cerebral venous thrombosis (CVT) is infrequently reported.
  • Further investigation into this specific complication of TBM is warranted.

Purpose of the Study:

  • To describe the clinical characteristics, imaging findings, and outcomes of patients with TBM and CVT.
  • To highlight CVT as a potential complication of TBM.

Main Methods:

  • Retrospective identification of 3 patients with TBM and CVT at Haihe Hospital.
  • Literature review and analysis of "Tuberculous meningitis" and "cerebral venous thrombosis" keywords.
  • Combination of case data with previously reported cases.

Main Results:

  • 28 patients with TBM and CVT were analyzed (median age 31 years, 17 female).
  • Common MRI findings included superior sagittal sinus thrombosis, hydrocephalus, infarction, and meningeal enhancement.
  • Mortality rate was 17.9%, with 75% achieving functional independence with anti-TB and anticoagulant treatments.

Conclusions:

  • Cerebral venous thrombosis (CVT) is a rare but significant complication of tuberculous meningitis (TBM).
  • Consider CVT in the differential diagnosis for TBM patients presenting with worsening clinical features or new neurological signs.
Keywords:
Anti-tuberculosis therapyCerebral venous thrombosisCerebrospinal fluidMagnetic resonance imagingTubercular meningitisVenous stroke

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