title: Invasive pressure monitoring saves from tuberculous meningitis with fulminant generalized brain edema.
abstract: We report a 57-year old female patient with a rapid and dramatic dynamic of whole brain edema caused by tuberculous meningitis. After initiation of tuberculostatic medication, general condition of the patient worsened and finally she was intubated due to a progredient loss of consciousness and respiratory insufficiency. Repeated cerebral computer tomography (CCT) revealed a global brain edema with slit ventricles and a dramatic progress of generalized brain swelling. Highly interesting, a rapid expanded regime of brain pressure monitoring and treatment according to a neurosurgical intensive standard ICP/CPP management protocol, which was complemented by the tuberculostatic therapy and high dose steroid application, dramatically improved the general conditions, so that the patient is now in a general condition which corresponds that before the occurrence of tuberculous meningitis. Thus, it is mandatory in situations with a rapid progressive brain swelling caused by bacterial meningitis to consider an intensified cerebral monitoring and stratified treatment protocol in order to avoid the devasting effects of a long lasting increase in intracranical pressure.
authors: Department of Neurology, Universitätsmedizin Göttingen Göttingen, Germany.
authors: George
authors: G
authors: Trendelenburg
authors: Daniel
authors: D
authors: Jussen
authors: Steffen
authors: S
authors: Grimmer
authors: Wibke
authors: W
authors: Jakob
authors: Nicola E
authors: NE
authors: Hiemann
authors: Peter
authors: P
authors: Horn