ABSTRACT
BACKGROUND: This study evaluated the prevalence and predictors of venographic abnormalities in tuberculous meningitis. MATERIAL AND METHODS: Consecutive patients of tuberculous meningitis were included in the study. Clinical evaluation, cerebrospinal fluid examination and contrast-enhanced MRI of brain were done. Every participant was subjected to time of flight magnetic resonance venography (MRV). Presence of filling defects at superior sagittal sinus, dominant transverse or sigmoid sinus, and non-visualization of deep venous system was considered suggestive of thrombosis. The presence of filling defects at non-dominant transverse or sigmoid sinus was considered suggestive of thrombosis only in the presence of corresponding changes in T1, T2, and GRE sequences, parenchymal changes or presence of collaterals. The patients were followed up for 6â¯months. A modified Barthel index ≤12 at 6â¯months was taken as poor outcome. RESULTS: Out of 107 patients, MRV was found to be abnormal in 12 patients (11.2%). The superior sagittal sinus was the most commonly involved sinus. On univariate analysis, the presence of vomiting (Pâ¯=â¯0.004), altered sensorium (Pâ¯=â¯0.004), seizures (Pâ¯<â¯0.001), vision impairment (Pâ¯=â¯0.038), papilledema (Pâ¯<â¯0.001), diplopia, oculomotor palsies, basal exudates (Pâ¯=â¯0.004) and MBI ≤12 at baseline (Pâ¯=â¯0.004) were significantly associated with an abnormal MRV. On multivariate analysis, none of the above factors were found to be significant. No association was found between an abnormal MRV and poor outcome. CONCLUSION: MRV abnormalities suggestive of venous sinus thrombosis can occur in about 11% patients. Superior sagittal sinus is the most commonly involved sinus. An abnormal MRV may not predict a poor outcome in patients with tuberculous meningitis.
Subject(s)
Cerebral Veins/diagnostic imaging , Magnetic Resonance Angiography/methods , Phlebography/methods , Tuberculosis, Meningeal/diagnostic imaging , Adolescent , Adult , Brain/blood supply , Brain/diagnostic imaging , Child , Female , Humans , Male , Middle Aged , Prospective Studies , Young AdultSubject(s)
Bartter Syndrome/diagnosis , Potassium/administration & dosage , Quadriplegia/diagnosis , Seizures/diagnosis , Bartter Syndrome/complications , Bartter Syndrome/drug therapy , Child , Humans , Male , Quadriplegia/drug therapy , Quadriplegia/etiology , Seizures/drug therapy , Seizures/etiologyABSTRACT
Dengue infection is gradually disseminating throughout the world in alarming proportions. It is a arbovirus infection,transmitted by aedes mosquitoes. It is a multi-systemic disorder associated with varied neurological complications. There is increased trend of development of neurological complications in dengue fever. The neurological complications arising due to dengue infection can be categorized into central and neuromuscular complications. The central nervous system disorders reported with dengue fever are encephalopathy,encephalitis and myelitis.Here we report a case of rhombencephalitis associated with dengue fever. The literature does not mention rhombencephalitis occurring with dengue illness.
