Introduction: Neuromeningeal tuberculosis is the most common form of extra-pulmonary tuberculosis in developing countries. It is the most serious form of Mycobacterium tuberculosis infection. Vascular complications of tuberculous meningitis involve functional prognosis of patients. Observation: In our daily practice, we frequently encounter cases of cerebral infarction associated with neuromeningeal tuberculosis in the infectious etiological balance. We report the case of an HIV immunocompetent patient hospitalized for neuromeningeal tuberculosis complicated with ischemic stroke. It was a 39-year-old patient, right-handed, admitted to the Neurology department of University Hospital of Cocody in whom the diagnosis of neuromeningeal tuberculosis was retained. She received treatment for tuberculosis in emergency. On the seventh day of hospitalization, she suddenly presented with a massive motor deficit of the left hemibody. The MRI performed was compatible with meningoencephalitis associated with recent deep right Sylvan ischemia foci. The evolution was marked by partial recovery of the left hemiplegia, right retro-bulbar neuritis, and iatrogenic hepatic cytolysis. Comments: Tuberculous meningitis remains today one of the most serious neurological conditions involving the vital and functional prognosis of patients. Association of cerebral infarction and tuberculous meningitis is of variable occurrence. There are reported cases in which cerebral infarction is a complication of tuberculous meningitis. On the other hand, the discovery of tuberculous meningitis can be observed in the assessment of a cerebral infarction in young subjects. Tuberculous meningovascularitis remains a rare condition in immunocompetent patients for HIVAIDS. It results from arterial occlusion by thrombosing and obliterating endarteritis. It represents a medical emergency requiring starting anti-tuberculosis treatment. The evolution depends on the precocity of the diagnosis and the speed of treatment. Conclusion: The sudden appearance of a neurological deficit in à patient with tuberculous meningitis even under specific treatment should suggest an ischemic stroke, especially if the symptomatology respects an anatomo-functional vascular systematization.
| Published in | American Journal of Psychiatry and Neuroscience (Volume 12, Issue 1) |
| DOI | 10.11648/j.ajpn.20241201.14 |
| Page(s) | 19-22 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Tuberculous Meningitis, Cerebral Infarction, Meningovasculitis, Immunocompetent HIV
| [1] | Morales S, Ramos W, Vílchez R, Pérez J, Alvarado M. Efficacy and safety of short- and long-term treatment regimens for tuberculous meningoencephalitis in two hospitals in Lima-Peru. 2011; 26(4): 220–226. |
| [2] | NY Mapoure, NHB Mbatchou, NH Luma. An ischemic stroke complicating tuberculous meningitis in an immunocompetent subject: interest of the PRC. 2013, 3(2). |
| [3] | Lee LV. Neurotuberculosis among Filipino children: an 11 years experience at the Philippine Children Center. Brain Dev 2000; 22: 469-474. |
| [4] | Y. Hsaini, J. Mounach, A Satté et al. Tuberculous meningovascularitis: about four cases. Neurological review. 2007, 197(4): 163. |
| [5] | Majid M, Cherif J. Epidémiologie of tuberculosis. Journal of Clinical Pneumology. 2015 April-June; 71(2-3): 67–72. |
| [6] | Bazin C Tuberculosis of the central nervous system Elseiver Masson 2004. |
| [7] | Bargach T, Elasri F, Elidrissi A, Messaoudi R, Fiqhi A, et al. Bilateral optic atrophy 6 years after tuberculous meningitis: About a case, 2011. |
| [8] | Cecchini D, Ambrosioni J, Brezzo C, Corti M, Rybko A, Perez M, Poggi S, Ambroggi M, (2009) Tuberculous meningitis in HIV-infected and non-infected patients: comparison of cerebrospinal fluid findings. Int J Tuberc Lung Dis 13: 269–271. |
| [9] | Springer P, Swanevelder S, van Toorn R, van Rensburg AJ, Schoeman J. Cerebral infarction and neurodevelopmental outcome in childhood tuberculous meningitis. Europ J Paediatr Neurol 2008; 30: 1-7. |
| [10] | Thwaites GE, Macmullen-Price J, Chau TTH, Mai PP, Dung NT, Simmons CP, et al. Serial MRI to determine the effect of dexamethasone on the cerebral pathology of tuberculous meningitis: an observational study. Lancet Neurol 2007; 6: 230-6. |
| [11] | Misra UK, Kalita J, Nair PP. Role of aspirin in tuberculous meningitis: a randomized open label placebo controlled trial. J Neurol Sci 2010; 293: 12–7. |
| [12] | Wasay M, Farooq S, Khowaja ZA, Bawa ZA, Ali SM, Awan S, et al. Cerebral infarction and tuberculoma in central nervous system tuberculosis: frequency and prognostic implications. J Neurol Neurosurg Psychiatry. 2014; 85(11): 1260–4. |
| [13] | Oppenheim C, Naggara O, Hamon M, Gauvrit JY, Rodrigo S, Bienvenu M et al. Diffusion magnetic resonance imaging of the brain in adults: technique, normal and pathological results. EMC, 2005; 30-806. |
APA Style
Tanoh, M. A., Aka, A., Yapo-Ehounoud, C., Tanoh, C. A., Kadjo, C., et al. (2024). Tuberculous Meningitis Complicated Without Deep Sylvian Cerebral Infarction: About an Immunocompetent Patient with HIV-AIDS. American Journal of Psychiatry and Neuroscience, 12(1), 19-22. https://doi.org/10.11648/j.ajpn.20241201.14
ACS Style
Tanoh, M. A.; Aka, A.; Yapo-Ehounoud, C.; Tanoh, C. A.; Kadjo, C., et al. Tuberculous Meningitis Complicated Without Deep Sylvian Cerebral Infarction: About an Immunocompetent Patient with HIV-AIDS. Am. J. Psychiatry Neurosci. 2024, 12(1), 19-22. doi: 10.11648/j.ajpn.20241201.14
AMA Style
Tanoh MA, Aka A, Yapo-Ehounoud C, Tanoh CA, Kadjo C, et al. Tuberculous Meningitis Complicated Without Deep Sylvian Cerebral Infarction: About an Immunocompetent Patient with HIV-AIDS. Am J Psychiatry Neurosci. 2024;12(1):19-22. doi: 10.11648/j.ajpn.20241201.14
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Download@article{10.11648/j.ajpn.20241201.14,
author = {Muriel Amon Tanoh and Arlette Aka and Constance Yapo-Ehounoud and Christian Abel Tanoh and Cédric Kadjo and Cédric Agbo and Delors Offoumou and Evelyne Aka-Anghui Diarra and Berthe Assi},
title = {Tuberculous Meningitis Complicated Without Deep Sylvian Cerebral Infarction: About an Immunocompetent Patient with HIV-AIDS},
journal = {American Journal of Psychiatry and Neuroscience},
volume = {12},
number = {1},
pages = {19-22},
doi = {10.11648/j.ajpn.20241201.14},
url = {https://doi.org/10.11648/j.ajpn.20241201.14},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajpn.20241201.14},
abstract = {Introduction: Neuromeningeal tuberculosis is the most common form of extra-pulmonary tuberculosis in developing countries. It is the most serious form of Mycobacterium tuberculosis infection. Vascular complications of tuberculous meningitis involve functional prognosis of patients. Observation: In our daily practice, we frequently encounter cases of cerebral infarction associated with neuromeningeal tuberculosis in the infectious etiological balance. We report the case of an HIV immunocompetent patient hospitalized for neuromeningeal tuberculosis complicated with ischemic stroke. It was a 39-year-old patient, right-handed, admitted to the Neurology department of University Hospital of Cocody in whom the diagnosis of neuromeningeal tuberculosis was retained. She received treatment for tuberculosis in emergency. On the seventh day of hospitalization, she suddenly presented with a massive motor deficit of the left hemibody. The MRI performed was compatible with meningoencephalitis associated with recent deep right Sylvan ischemia foci. The evolution was marked by partial recovery of the left hemiplegia, right retro-bulbar neuritis, and iatrogenic hepatic cytolysis. Comments: Tuberculous meningitis remains today one of the most serious neurological conditions involving the vital and functional prognosis of patients. Association of cerebral infarction and tuberculous meningitis is of variable occurrence. There are reported cases in which cerebral infarction is a complication of tuberculous meningitis. On the other hand, the discovery of tuberculous meningitis can be observed in the assessment of a cerebral infarction in young subjects. Tuberculous meningovascularitis remains a rare condition in immunocompetent patients for HIVAIDS. It results from arterial occlusion by thrombosing and obliterating endarteritis. It represents a medical emergency requiring starting anti-tuberculosis treatment. The evolution depends on the precocity of the diagnosis and the speed of treatment. Conclusion: The sudden appearance of a neurological deficit in à patient with tuberculous meningitis even under specific treatment should suggest an ischemic stroke, especially if the symptomatology respects an anatomo-functional vascular systematization.
},
year = {2024}
}
TY - JOUR T1 - Tuberculous Meningitis Complicated Without Deep Sylvian Cerebral Infarction: About an Immunocompetent Patient with HIV-AIDS AU - Muriel Amon Tanoh AU - Arlette Aka AU - Constance Yapo-Ehounoud AU - Christian Abel Tanoh AU - Cédric Kadjo AU - Cédric Agbo AU - Delors Offoumou AU - Evelyne Aka-Anghui Diarra AU - Berthe Assi Y1 - 2024/02/20 PY - 2024 N1 - https://doi.org/10.11648/j.ajpn.20241201.14 DO - 10.11648/j.ajpn.20241201.14 T2 - American Journal of Psychiatry and Neuroscience JF - American Journal of Psychiatry and Neuroscience JO - American Journal of Psychiatry and Neuroscience SP - 19 EP - 22 PB - Science Publishing Group SN - 2330-426X UR - https://doi.org/10.11648/j.ajpn.20241201.14 AB - Introduction: Neuromeningeal tuberculosis is the most common form of extra-pulmonary tuberculosis in developing countries. It is the most serious form of Mycobacterium tuberculosis infection. Vascular complications of tuberculous meningitis involve functional prognosis of patients. Observation: In our daily practice, we frequently encounter cases of cerebral infarction associated with neuromeningeal tuberculosis in the infectious etiological balance. We report the case of an HIV immunocompetent patient hospitalized for neuromeningeal tuberculosis complicated with ischemic stroke. It was a 39-year-old patient, right-handed, admitted to the Neurology department of University Hospital of Cocody in whom the diagnosis of neuromeningeal tuberculosis was retained. She received treatment for tuberculosis in emergency. On the seventh day of hospitalization, she suddenly presented with a massive motor deficit of the left hemibody. The MRI performed was compatible with meningoencephalitis associated with recent deep right Sylvan ischemia foci. The evolution was marked by partial recovery of the left hemiplegia, right retro-bulbar neuritis, and iatrogenic hepatic cytolysis. Comments: Tuberculous meningitis remains today one of the most serious neurological conditions involving the vital and functional prognosis of patients. Association of cerebral infarction and tuberculous meningitis is of variable occurrence. There are reported cases in which cerebral infarction is a complication of tuberculous meningitis. On the other hand, the discovery of tuberculous meningitis can be observed in the assessment of a cerebral infarction in young subjects. Tuberculous meningovascularitis remains a rare condition in immunocompetent patients for HIVAIDS. It results from arterial occlusion by thrombosing and obliterating endarteritis. It represents a medical emergency requiring starting anti-tuberculosis treatment. The evolution depends on the precocity of the diagnosis and the speed of treatment. Conclusion: The sudden appearance of a neurological deficit in à patient with tuberculous meningitis even under specific treatment should suggest an ischemic stroke, especially if the symptomatology respects an anatomo-functional vascular systematization. VL - 12 IS - 1 ER -
Department des Sciences Médicales, University Félix Houphouët Boigny, Abidjan, République de Côte d’Ivoire
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