Clinical characteristics and treatment delay of cerebral infarction in tuberculous meningitis
Journal
Internal Medicine Journal
Journal Volume
42
Journal Issue
3
Pages
294-300
ISSN
1445-5994
Date Issued
2012-03
Author(s)
Abstract
Background: Cerebral infarction (CI) complicating tuberculous meningitis (TBM) is a major risk factor of permanent disability. The prevention of this complication is an important issue in the quality care of TBM patients. Aim: Our aim was to evaluate the clinical characteristics of TBM patients with CI. Methods: Ninety-one adult patients with TBM were studied between 1999 and 2007. Clinical, neuroradiological and cerebrospinal fluid data of patients with CI were compared with those without CI. Results: Thirty of the 91 patients had CI, including symptomatic CI occurring before admission in 10 patients, symptomatic CI occurring during hospitalisation in four and silent CI in 16 patients. When compared with non-CI patients, patients with CI were younger and associated with focal weakness on presentation, and had basal meningeal enhancement and hydrocephalus on brain images. Prolonged doctor delays of antituberculosis and steroid therapies, neurosurgical intervention, focal weakness and dementia as sequelae, and poor outcomes were associated with patients with CI than non-CI patients. Conclusion: Contrast-enhanced brain imaging is helpful to explore the basal meningeal enhancement in CI patients, and contributes to early diagnosis and treatment of TBM. Early antituberculosis and steroid therapies may help prevent CI in TBM patients. ? 2010 The Authors. Journal compilation ? 2010 Royal Australasian College of Physicians.
SDGs
Other Subjects
steroid; tuberculostatic agent; adult; article; basal ganglion; brain infarction; capsula interna; central nervous system infection; cerebrospinal fluid; computer assisted tomography; contrast enhancement; controlled study; dementia; early diagnosis; female; fever; follow up; headache; hospital admission; hospitalization; human; hydrocephalus; major clinical study; male; neuroimaging; neurosurgery; nuclear magnetic resonance imaging; priority journal; pyrexia idiopathica; steroid therapy; stroke; subcortex; thalamus; therapy delay; treatment outcome; tuberculous meningitis; weakness; Adrenal Cortex Hormones; Adult; Antitubercular Agents; Brain Damage, Chronic; Cerebral Infarction; Contrast Media; Delayed Diagnosis; Female; Humans; Inpatients; Magnetic Resonance Imaging; Male; Neuroimaging; Retrospective Studies; Taiwan; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Tuberculosis, Meningeal
Type
journal article