Acute Stroke in Tubercular Meningitis: A Case Report

  • Suzit Bhusal Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
  • Sujata Dahal Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
  • Neha Gautam Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
  • Prakash Banjade Manipal College of Medical Sciences, Pokhara, Nepal
Keywords: meningeal tuberculosis; stroke; tuberculoma; vasculitis.

Abstract

Most of the strokes in tubercular meningitis are multiple, bilateral, and located in the basal ganglia, especially the ‘tubercular zone’, which comprises of the caudate, anterior thalamus, anterior limb, and genu of the internal capsule. These are attributed to the involvement of medial striate, thalamotuberal, and thalamostriate arteries, which are embedded in exudates and likely to be stretched by coexistent hydrocephalus. Corticosteroids with antitubercular therapy were thought to reduce mortality and morbidity but their role in lowering strokes has not been proven. The mechanism of stroke in our case was vasculitis. Here, we are reporting a case of 22-years female patient with tubercular meningitis. She had complications of ischemic infarct and severe communicating hydrocephalus with a seizure disorder.

Published
2019-10-31
How to Cite
Bhusal, S., Dahal, S., Gautam, N., & Banjade, P. (2019). Acute Stroke in Tubercular Meningitis: A Case Report. Journal of Nepal Medical Association, 57(219). https://doi.org/10.31729/jnma.4646
Section
Case Reports