title: Cerebral infarcts complicating tuberculous meningitis.
abstract: Cerebral infarction (CI) is a serious complication of tuberculous meningitis (TBM). It can be asymptomatic or symptomatic, causing stroke. We studied 40 TBM patients. All had initial CT brain scan, CT/MRI brain scan 3 months later and urgent CT brain scan for deterioration. CI was classified into lacunar infarction (LI) or large artery infarction (LAI). Twelve (30%) had CI, in 9 (23%) it was symptomatic and in 3 (8%) silent. Seven (58%) had LAI +/- LI. Eight (67%) had multiple CI. Two died from brainstem CI and 6 were dependent at 1 year. Patients with LAI might develop posterior circulation CI more frequently than those with LI only. CI is a common complication of TBM locally, with LAI and multiple CI being common. Two thirds of TBM patients complicated by CI had poor prognosis despite adjunctive dexamethasone treatment.
authors.affiliation: Division of Neurology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, SAR, China. koonhochan@hotmail.com
authors.forename: K H
authors.initials: KH
authors.lastname: Chan
authors.forename: R T F
authors.initials: RT
authors.lastname: Cheung
authors.forename: R
authors.initials: R
authors.lastname: Lee
authors.forename: W
authors.initials: W
authors.lastname: Mak
authors.forename: S L
authors.initials: SL
authors.lastname: Ho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000209:etiology*; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014390:Tuberculosis, Meningeal / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone