title: Stages of tuberculous meningitis: a clinicoradiologic analysis.
abstract: OBJECTIVE
  To determine the frequencies and percentages of various clinicoradiologic variables of tuberculosis meningitis (TBM) with reference to British Medical Research Council (BMRC) staging of the disease.
  
  
  METHODS
  A case series.
  
  
  METHODS
  Department of Neurology, Jinnah Postgraduate Medical Centre, Karachi, from October 2010 to September 2011.
  
  
  METHODS
  The study included 93 adult patients with the diagnosis of tuberculous meningitis (TBM) at the study place. Patients were divided in three groups according to British Medical Research Council (BMRC) staging of TBM. Different clinical and radiological findings were analyzed at different stages of the disease. Data was analyzed using SPSS (Statistical Package of Social Sciences) version 11.0.
  
  
  RESULTS
  A majority of patients were found to be in stage-II disease at the time of admission. History of illness at the time of admission was more than 2 weeks in 50% of stage-I patients but around 80% in stage-II and stage-III patients. Neck stiffness was the most commonly reported finding in all stages. Cranial nerve palsies were higher in stage-III (75%) than in stage-II (43%) and in stage-I (24%) patients. Hydrocephalus and basal enhancement was the most frequently reported radiographic abnormalities.
  
  
  CONCLUSIONS
  Duration of illness and cranial nerve palsies are important variables in the diagnosis of TBM stages and if TBM is suspected, empiric treatment should be started immediately without bacteriologic proof to prevent morbidity and mortality.
authors.affiliation: Department of Neurology, Jinnah Postgraduate Medical Centre, Karachi. drkhalidsher@gmail.com
authors.forename: Khalid
authors.initials: K
authors.lastname: Sher
authors.lastname: Firdaus
authors.forename: Amanullah
authors.initials: A
authors.lastname: Abbasi
authors.forename: Naeemullah
authors.initials: N
authors.lastname: Bullo
authors.forename: Suneel
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D018450:Disease Progression; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000382:microbiology; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D010154:Pakistan / Q000453:epidemiology; D011379:Prognosis; D011859:Radiography; D012720:Severity of Illness Index; D014390:Tuberculosis, Meningeal / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents