CT OF THE BRAIN IN TUBERCULOUS MENINGITIS: A review of 289 patients

2000 ◽  
Vol 41 (1) ◽  
pp. 13-17
Author(s):  
M. Özateş ◽  
S. Kemalogˇlu ◽  
F. Gürkan ◽  
Özkan Ü. ◽  
Not Available Not Available ◽  
...  
Keyword(s):  
Tuberculous Meningitis ◽  
The Brain

scholarly journals Is mercury injected into the body for therapeutic purposes released into the spinal fluid?

1912 ◽  
Vol XIX (4) ◽  
pp. 803-813
Author(s):  
V. Lazarev
Keyword(s):  
Tuberculous Meningitis ◽  
Nervous Tissue ◽  
Direct Action ◽  
The Body ◽  
Spinal Fluid ◽  
Bile Pigment ◽  
Vascular Plexus ◽  
Points Of View ◽  
The Brain ◽  
Theoretical Side

Is mercury injected into the body excreted into the spinal fluid? This question occupied us with practical and theoretical points of view. On the practical side, we were interested in knowing how much we can count on the circulation of mercury in the spinal fluid and, therefore, on its direct action on the nervous tissue due to the communication of the perivascular (and pericellular) spaces with the sub-arachnoid. If mercury is released into the spinal fluid, it is necessary to search for the therapeutic effect (syphilis of the nervous system) of the drug that quickly and in large quantities passes into the spinal fluid. On the theoretical side, the issue of mercury release is of interest for solving the broader issue of the nature of spinal fluid in general. As is known, there is currently no agreement on this account. Is the spinal fluid transudate, the secretion of the vascular plexus epithelium or the sui generis lymph of the brain itself. In favor of the second1 views are inclined by Schultze, Imamura, Raubitschek, Molt, and others in favor of the last but Spina2 (also Lewandovsky and Blumenthal3. The first view is generally accepted. We thought that the saturation of blood with mercury, which happens with prolonged introduction of it into the body, should lead to the appearance of at least traces of it in the spinal fluid, if the latter is transudate. If the last secret, then apriori nothing can be predicted; extraction depends on the chemical and physical properties of the epithelium itself; the epithelium can secerne one substance and not pass another. The number of substances found so far in the spinal fluid when injected into the body is very limited. When the brain (and membranes) was normal, the substances introduced by the authors did not completely enter the spinal fluid. Widal, Monod4, Sicard was found in tuberculous meningitis iod when giving it during 2-3 days for 3-5 grams only in 3 cases. Guinon and Simon found only 1/2 cases of tuberculous meningitis; no iodine was found in cases of cerebrospinal meningitis. With uremia, Costaigne found iod and methylene blue. Sicard and Widal didnt find it. Gilbert and Castaigne found bile pigment in jaundice. Sicard denies. Archard Loeper5 did not find the lithium when it was injected into the blood. Regarding the fate of mercury introduced into the organism, there are no indications in the literature6.

Low Spinal Fluid Sugar in Meningitis

PEDIATRICS ◽  
1970 ◽  
Vol 45 (4) ◽  
pp. 717-718
Author(s):  
Manfred Weichsel
Keyword(s):  
Bacterial Meningitis ◽  
Glucose Transport ◽  
Tuberculous Meningitis ◽  
Spinal Fluid ◽  
The Brain

Dr. John H. Menkes's review of the factors responsible for the lowering of the spinal fluid sugar in bacterial and tuberculous meningitis1 presents evidence that the primary factors for the low spinal fluid sugar in bacterial meningitis may be a combination of increased utilization of glucose by the brain, combined with a defective glucose transport. We2 presented evidence over 30 years ago that the lowering of the spinal fluid sugar in tuberculous meningitis was not due predominantly to utilization of the glucose by either bacteria or leukocytes:

scholarly journals A Case of Diffuse Leptomeningeal Glioneuronal Tumor Misdiagnosed as Chronic Tuberculous Meningitis without Brain Biopsy

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Jung koo Lee ◽  
Hak-cheol Ko ◽  
Jin-gyu Choi ◽  
Youn Soo Lee ◽  
Byung-chul Son
Keyword(s):  
Tuberculous Meningitis ◽  
Glioneuronal Tumor ◽  
Communicating Hydrocephalus ◽  
Laboratory Findings ◽  
Cytologic Examination ◽  
Mental Confusion ◽  
Leptomeningeal Enhancement ◽  
Diffuse Leptomeningeal Glioneuronal Tumor ◽  
The Brain ◽  
Basal Cisterns

Here we report a rare case of diffuse leptomeningeal glioneuronal tumor (DLGNT) in a 62-year-old male patient misdiagnosed as having tuberculous meningitis. Due to its rarity and radiologic findings of leptomeningeal enhancement in the basal cisterns on magnetic resonance imaging (MRI) similar to tuberculous meningitis, DLGNT in this patient was initially diagnosed as communicating hydrocephalus from tuberculous meningitis despite absence of laboratory findings of tuberculosis. The patient’s symptoms and signs promptly improved after a ventriculoperitoneal shunting surgery followed by empirical treatment against tuberculosis. Five years later, mental confusion and ataxic gait developed in this patient again despite well-functioning ventriculoperitoneal shunt. Aggravation of leptomeningeal enhancement in the basal cisterns was noted in MRI. An additional course of antituberculosis medication with steroid was started without biopsy of the brain. Laboratory examinations for tuberculosis were negative again. After four months of improvement, his mental confusion, memory impairment, dysphasia, and ataxia gradually worsened. A repeated MRI of the brain showed further aggravation of leptomeningeal enhancement in the basal cisterns. Biopsy of the brain surface and leptomeninges revealed a very rare occurrence of DLGNT. His delayed diagnosis of DLGNT might be due to prevalence of tuberculosis in our country, similarity in MRI finding of prominent leptomeningeal enhancement in the basal cisterns, and extreme rarity of DLGNT in the elderly. DLGLT should be considered in differential diagnosis of medical conditions presenting as communicating hydrocephalus with prominent leptomeningeal enhancement. A timely histologic diagnosis through a leptomeningeal biopsy of the brain and spinal cord in case of unusual leptomeningeal enhancement with uncertain laboratory findings is essential because cytologic examination of the cerebrospinal fluid in DLGNT is known to be negative.

scholarly journals Evolving Stroke in Tuberculous Meningitis

2021 ◽  
Author(s):  
Seng Wee Cheo ◽  
Rosdina Zamrud Ahmad Akbar ◽  
Song Weng Ryan Khoo ◽  
Yee Ann Tan ◽  
Qin Jian Low
Keyword(s):  
Tuberculous Meningitis ◽  
Neurological Complication ◽  
Severe Form ◽  
High Morbidity ◽  
Timely Initiation ◽  
Extra Pulmonary Tuberculosis ◽  
Aggressive Disease ◽  
Ct Brain ◽  
The Brain

Tuberculous meningitis (TBM) is the most severe form of extra-pulmonary tuberculosis which carries high mortality with 100% mortality without treatment. A neurological complication of TBM includes hydrocephalus, brain abscess and stroke. In this report, we would like to illustrate a case of stroke in a patient with TBM. In this case, a 37-year old man initially presented with fever for 1 week associated with severe headache and occasional vomiting. Computed tomography (CT) of the brain showed leptomeningeal enhancement and lumbar puncture findings consistent with infective in nature. His MARAIS score was 13 and was treated as tuberculous meningitis with anti-tuberculous therapy. While in the ward, he developed right-sided body weakness with evolving CT brain findings. His condition then stabilized with anti-tuberculous treatment which consists of isoniazid, rifampicin, pyrazinamide and streptomycin. Dexamethasone was also initiated. On follow up, his condition further improves and is functionally independent. In conclusion, tuberculous meningitis is an aggressive disease with high morbidity. Stroke can occur as a result of TBM. Timely initiation of treatment is important in improving the outcome of the patients.

Abscess in Frontal Lobe: Post-Mortem Findings in Case Shown at a Previous Meeting of the Section with Elizabeth O’Flynn

2016 ◽  
pp. 119-122
Author(s):  
Donald W. Winnicott ◽  
Elizabeth O’Flynn
Keyword(s):  
Frontal Lobe ◽  
Tuberculous Meningitis ◽  
Right Hemisphere ◽  
Post Mortem ◽  
Anterior Half ◽  
Intracranial Disease ◽  
Post Mortem Findings ◽  
The Right ◽  
The Brain ◽  
Important Disease

Winnicott and O’Flynn present the case of a six-year-old at death, who had been under observation at the Queen’s Hospital for Children for several years. Besides the odd complaints from which she suffered, it was always felt that some more important disease might be present. The child always did well in hospital and at the convalescent home. Later, acute symptoms pointed directly to intracranial disease, and tuberculous meningitis was expected. A postmortem report revealed a large abscess in the right frontal lobe of the brain, involving the whole anterior half of the right hemisphere, and extremely congested kidneys.

AUDITORY STIMULATION OF QUR’ANIC MUROTTAL ON PATIENT WITH TUBERCULOUS MENINGITIS

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Raudha Ilmi Farid ◽  
Sri Yona
Keyword(s):  
Tuberculous Meningitis ◽  
Clinical Signs ◽  
Nursing Intervention ◽  
Pain Scale ◽  
Study Analysis ◽  
Case Study Analysis ◽  
Relieve Pain ◽  
The Brain ◽  
Stimulation Of

<p><strong>Objective</strong>:One of serious complications of tuberculosis is tuberculous meningitis that affects the brain. Headache and pain are among clinical signs manifesting in patient with TB meningitis. Modification of interventions to treat pain in clients with TB meningitis is necessary. Providing stimulation of Qur'anic Murottal as an effort to relieve pain may be used as a modification of intervention.</p><p> </p><p><strong>Methods:</strong> This study used case study analysis of patient with meningitis TB in Neurology Ward of RSCM for 7 days. Patient was provided with murottal al qur'an stimulation for seven days and the level of pain was evaluated by using Adult Nonverbal Pain Scale instrument.</p><p> </p><p><strong>Results</strong>: The study result indicated that there was a decrease in pain level according to Adult Non-Verbal Pain Scale (ANVPS) score from 7 to 1.</p><p> </p><p><strong>Conclusion</strong>: The development of further research in audio stimulation application of murottal al qur'an on client with TB meningitis should be conducted as an innovation of nursing intervention for client affected by pain, especially TB meningitis.</p><div><p class="KeywordsCxSpFirst"> </p><p class="KeywordsCxSpLast"><strong>Keywords:</strong> meningitis, murottal al qur’an, pain, tuberculosis</p></div>

scholarly journals Imaging Features of the Brain, Cerebral Vessels and Spine in Pediatric Tuberculous Meningitis With Associated Hydrocephalus

2016 ◽  
Vol 35 (10) ◽  
pp. e301-e310 ◽  
Author(s):  
Ursula K. Rohlwink ◽  
Tracy Kilborn ◽  
Nicky Wieselthaler ◽  
Ebrahim Banderker ◽  
Eugene Zwane ◽  
...  
Keyword(s):  
Tuberculous Meningitis ◽  
Cerebral Vessels ◽  
Imaging Features ◽  
The Brain

En plaque intradural extramedullary spinal tuberculoma and concurrent intracranial tuberculomas: paradoxical response to antituberculous therapy

2007 ◽  
Vol 6 (2) ◽  
pp. 169-173 ◽  
Author(s):  
Natarajan Muthukumar ◽  
Venkatachalam Sureshkumar ◽  
Vengalathur Ganesan Ramesh
Keyword(s):  
Tuberculous Meningitis ◽  
Thoracic Myelopathy ◽  
Paradoxical Response ◽  
Response To Chemotherapy ◽  
Intradural Extramedullary ◽  
Lower Thoracic Spine ◽  
Compressive Myelopathy ◽  
The Brain ◽  
Antituberculous Chemotherapy ◽  
Definitive Role

✓Spinal intradural extramedullary tuberculoma is a rare entity. Rarer still are extensive en plaque intradural extramedullary tuberculomas occurring concurrently with multiple intracranial tuberculomas as a paradoxical response to chemotherapy for tuberculosis (TB). The authors describe the case of a 21-year-old man who was treated for tuberculous meningitis. Three months after the episode of meningitis, while undergoing chemotherapy for TB, he developed features of thoracic myelopathy. Investigations revealed an extensive en plaque intradural extramedullary lesion spanning seven segments in the lower thoracic spine. Magnetic resonance imaging of the brain revealed multiple asymptomatic intracranial tuberculomas. Even after further treatment with antituberculous chemotherapy was initiated, the lesion failed to respond. The authors performed a laminectomy and excised the en plaque intradural extramedullary lesion. The patient’s condition responded well to this treatment. Although the appearance of intracranial tuberculoma as a paradoxical response to chemotherapy has been previously reported, no authors have reported on the development of an extensive en plaque intradural extramedullary tuberculoma in conjunction with asymptomatic multiple intracranial tuberculomas as a paradoxical response. In cases in which patients present with compressive myelopathy following therapy for tuberculous meningitis, it is important to consider in the differential diagnosis that intradural extramedullary tuberculoma may be a paradoxical response to chemotherapy. The authors’ experience and their review of the literature indicate that surgery has a definitive role to play in the management of spinal intradural extramedullary tuberculoma.

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