title: Tuberculous cerebral vasculitis: retrospective study of 10 cases.
abstract: BACKGROUND
  Tuberculous cerebral vasculitis is a complication of tuberculous meningitis. This study was undertaken to determine the epidemiological characteristics, context, diagnostic means and outcomes under treatment of tuberculous cerebral vasculitides.
  
  
  METHODS
  All consecutive patients diagnosed with tuberculous cerebral vasculitis were identified from the databases of three Internal Medicine, one Neurology and one Infectious Disease Departments in three suburban Parisian hospitals.
  
  
  RESULTS
  We describe 10 cases: five men and five women (median age 33.5 [range: 27-55] years). Two were infected with the human immunodeficiency virus. Nine patients had tuberculous meningitis, eight with extraneurological involvement. The following manifestations led to the diagnosis: motor deficit, acute confusional state, headaches, involvement, coma and/or seizures. The cerebral vasculitis revealed tuberculosis in three patients, but tuberculosis was already known when vasculitis was diagnosed for the seven others. The cerebral computed-tomography scan showed cerebral infarctions in five patients, hydrocephalus and tuberculomas in four, while magnetic resonance imaging detected infarctions and leptomeningitis in nine patients, pachymeningitis in one, hydrocephalus and tuberculomas in seven. Therapy combined antituberculous agents with oral corticosteroids for all patients, preceded by a methylprednisolone pulse for five patients. Outcome was favorable for nine patients.
  
  
  CONCLUSIONS
  We described the non-negligible frequency of tuberculous cerebral vasculitides, their clinical manifestations and their potential severity, and the diagnostic and monitoring contributions of magnetic resonance imaging and magnetic resonance angiography.
authors.affiliation: Service des Urgences, Hôpital Jean-Verdier, Assistance Publique-Hôpitaux de Paris, Université Paris 13, Bondy Cedex, France. nicolas.javaud@jvr.aphp.fr
authors.forename: Nicolas
authors.initials: N
authors.lastname: Javaud
authors.forename: Rita Da Silva
authors.initials: Rda S
authors.lastname: Certal
authors.forename: Jérôme
authors.initials: J
authors.lastname: Stirnemann
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Morin
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Chamouard
authors.forename: Alexandre
authors.initials: A
authors.lastname: Augier
authors.forename: Olivier
authors.initials: O
authors.lastname: Bouchaud
authors.forename: Antoine
authors.initials: A
authors.lastname: Carpentier
authors.forename: Robin
authors.initials: R
authors.lastname: Dhote
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Dumas
authors.forename: Bruno
authors.initials: B
authors.lastname: Fantin
authors.forename: Olivier
authors.initials: O
authors.lastname: Fain
mesh_terms: D000328:Adult; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014388:Tuberculosis, Lymph Node / Q000134:cerebrospinal fluid / Q000453:epidemiology; D014390:Tuberculosis, Meningeal / Q000134:cerebrospinal fluid / Q000453:epidemiology* / Q000473:pathology; D014397:Tuberculosis, Pulmonary / Q000134:cerebrospinal fluid / Q000453:epidemiology; D014400:Tuberculosis, Splenic / Q000134:cerebrospinal fluid / Q000453:epidemiology; D020293:Vasculitis, Central Nervous System / Q000453:epidemiology* / Q000382:microbiology* / Q000473:pathology