title: Magnetic resonance angiography manifestations and prognostic significance in HIV-negative tuberculosis meningitis.
abstract: OBJECTIVE
  To evaluate the patterns, related factors and prognostic value of abnormal magnetic resonance angiography (MRA) in human immunodeficiency virus negative tuberculous meningitis.
  
  
  METHODS
  We performed a prospective study in patients aged >14 years. Abnormality on MRA was correlated with clinical, laboratory and magnetic resonance imaging findings. Modified Barthel index was used to assess outcome at 6 months after inclusion.
  
  
  RESULTS
  Of 101 patients included, MRA was abnormal in 45 (44.6%). The distribution of MRA abnormality was classified as disseminated irregular calibres of intracranial arteries with or without reduction in distant branches (29.7%, pattern 1) and localised stenosis at the base of the brain (26.7%, pattern 2). In logistic regression analysis, pattern 2 was related to stage of the disease (P = 0.002), basal exudates (P = 0.03) and infarction (P = 0.000), while pattern 1 was related to duration of disease (P = 0.050), hydrocephalus (P = 0.032) and age (P = 0.002). Pattern 1 was also correlated with infarction (P = 0.000), particularly infarction in the tubercular zone (P = 0.035) in univariate analysis. MRA abnormality was associated with paradoxical worsening (P = 0.022) and poor prognosis in univariate analysis (P = 0.035).
  
  
  CONCLUSIONS
  MRA abnormality is associated with stroke and poor outcomes. Although it indicates mild vascular injury, pattern 1 MRA abnormality is nevertheless associated with infarction and needs proper intervention.
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: T-T
authors.initials: TT
authors.lastname: Lu
authors.affiliation: State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
authors.forename: X-Q
authors.initials: XQ
authors.lastname: Lin
authors.affiliation: Department of Neurology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China.
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: W
authors.initials: W
authors.lastname: Cai
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Y-Q
authors.initials: YQ
authors.lastname: Dai
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Z-Z
authors.initials: ZZ
authors.lastname: Lu
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: A-M
authors.initials: AM
authors.lastname: Wu
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: J
authors.initials: J
authors.lastname: Bao
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: X-Q
authors.initials: XQ
authors.lastname: Hu
authors.affiliation: Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: Z-Q
authors.initials: ZQ
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003251:Constriction, Pathologic / Q000175:diagnosis; D005260:Female; D018023:HIV Seronegativity; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis*; D016015:Logistic Models; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D020521:Stroke / Q000150:complications*; D014390:Tuberculosis, Meningeal / Q000150:complications*; D055815:Young Adult