Cerebral infarction pattern in tuberculous meningitis

Tuberculous meningitis (TBM) causes significant morbidity and mortality. The primary objective was to re-examine the concept of "TB zone" and "ischaemic zone" in cerebral infarction in patients with tuberculous meningitis. The secondary objective was to evaluate cerebral infarcti...

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Main Author: Tai, M.L.S.
Format: Article
Language:English
Published: Nature Publishing Group 2016
Subjects:
Online Access:http://eprints.um.edu.my/17702/1/Tai%2C_M.L.S._%282016%29.pdf
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author Tai, M.L.S.
author_facet Tai, M.L.S.
author_sort Tai, M.L.S.
collection UM
description Tuberculous meningitis (TBM) causes significant morbidity and mortality. The primary objective was to re-examine the concept of "TB zone" and "ischaemic zone" in cerebral infarction in patients with tuberculous meningitis. The secondary objective was to evaluate cerebral infarction, vasculitis and vasospasm in tuberculous meningitis infections. Between 2009 and 2014, TBM patients were recruited. Neuroimaging was performed and findings of cerebral infarction, vasculitis and vasospasm were recorded. Infarcts were classified based on arterial supply and Hsieh's classification. Fifty-one TBM patients were recruited of whom 34 patients (67%) had cerebral infarction. Based on Hsieh's classification, 20 patients (59%) had infarcts in both "TB zone" and "ischaemic zones". 12 patients (35%) had infarcts in "ischaemic zone" and two (6%) patients had infarcts in "TB zone". In terms of vascular supply, almost all patients (35/36) had infarcts involving perforators and cortical branches. 25 patients (73%) and 14 patients (41%) had infarcts supplied by lateral lenticulostriate and medial lenticulostriate arteries respectively. 15 patients (37%) had vasculitis. Vasospasm was present in six patients (15%). 29 patients (85%) with cerebral infarction also had leptomeningeal enhancement (p = 0.002). In summary, infarcts involved mainly perforators and cortical branches, rather than "TB zone" versus "ischaemic zone".
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spelling um.eprints-177022017-08-15T02:15:06Z http://eprints.um.edu.my/17702/ Cerebral infarction pattern in tuberculous meningitis Tai, M.L.S. R Medicine Tuberculous meningitis (TBM) causes significant morbidity and mortality. The primary objective was to re-examine the concept of "TB zone" and "ischaemic zone" in cerebral infarction in patients with tuberculous meningitis. The secondary objective was to evaluate cerebral infarction, vasculitis and vasospasm in tuberculous meningitis infections. Between 2009 and 2014, TBM patients were recruited. Neuroimaging was performed and findings of cerebral infarction, vasculitis and vasospasm were recorded. Infarcts were classified based on arterial supply and Hsieh's classification. Fifty-one TBM patients were recruited of whom 34 patients (67%) had cerebral infarction. Based on Hsieh's classification, 20 patients (59%) had infarcts in both "TB zone" and "ischaemic zones". 12 patients (35%) had infarcts in "ischaemic zone" and two (6%) patients had infarcts in "TB zone". In terms of vascular supply, almost all patients (35/36) had infarcts involving perforators and cortical branches. 25 patients (73%) and 14 patients (41%) had infarcts supplied by lateral lenticulostriate and medial lenticulostriate arteries respectively. 15 patients (37%) had vasculitis. Vasospasm was present in six patients (15%). 29 patients (85%) with cerebral infarction also had leptomeningeal enhancement (p = 0.002). In summary, infarcts involved mainly perforators and cortical branches, rather than "TB zone" versus "ischaemic zone". Nature Publishing Group 2016 Article PeerReviewed application/pdf en http://eprints.um.edu.my/17702/1/Tai%2C_M.L.S._%282016%29.pdf Tai, M.L.S. (2016) Cerebral infarction pattern in tuberculous meningitis. Scientific Reports, 6 (1). ISSN 2045-2322, DOI https://doi.org/10.1038/srep38802 <https://doi.org/10.1038/srep38802>. http://dx.doi.org/10.1038/srep38802 doi:10.1038/srep38802
spellingShingle R Medicine
Tai, M.L.S.
Cerebral infarction pattern in tuberculous meningitis
title Cerebral infarction pattern in tuberculous meningitis
title_full Cerebral infarction pattern in tuberculous meningitis
title_fullStr Cerebral infarction pattern in tuberculous meningitis
title_full_unstemmed Cerebral infarction pattern in tuberculous meningitis
title_short Cerebral infarction pattern in tuberculous meningitis
title_sort cerebral infarction pattern in tuberculous meningitis
topic R Medicine
url http://eprints.um.edu.my/17702/1/Tai%2C_M.L.S._%282016%29.pdf
work_keys_str_mv AT taimls cerebralinfarctionpatternintuberculousmeningitis