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Caudate Head Ischemic Stroke with Concurrent Tubercular Meningoencephalitis: A Case Report
Filippo Nuti1, Giulia Ruocco1, Patrizia Pasculli2
1Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy.
Reports (MDPI)
|July 25, 2025
Summary
This case study explores tubercular meningoencephalitis with ischemic stroke, highlighting diagnostic and therapeutic challenges. Early recognition and multidisciplinary care are crucial for managing this complex neurological condition.
Area of Science:
- Neurology
- Infectious Diseases
Background:
- The pathogenesis of ischemic lesions in tubercular meningoencephalitis is not well understood.
- Optimal therapeutic strategies for acute and secondary prevention are unclear.
Observation:
- An atypical case of TBM with a concurrent ischemic stroke is presented.
- Clinical-radiological discrepancies suggested an infectious etiology for the ischemic lesion.
- The patient experienced neurological deterioration despite initial antitubercular therapy, necessitating hydrocephalus management via an external ventricular shunt.
Findings:
- External ventricular shunting improved the patient's clinical condition by reducing ventricular size.
- Secondary prophylaxis with cardioaspirin was initiated to mitigate the risk of mortality.
- The case underscores the complexity of managing TBM with concomitant ischemic stroke.
Implications:
- This case highlights the critical need for early recognition and comprehensive evaluation in TBM patients with ischemic stroke.
- Multidisciplinary management is essential for optimizing outcomes in these complex neurological cases.
- Further research into TBM pathogenesis and acute/preventive treatment strategies is warranted.
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