A rare presentation of cerebral venous sinus thrombosis associated with tubercular meningitis

Verma, Rajesh; Lalla, Rakesh; Patil, Tushar; Tiwari, Neema

doi:10.1136/bcr-2013-009892

Cited by 23 publications

(18 citation statements)

References 15 publications

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“…TB meningitis accounts for about 1% of all cases of TB and 6% of all extrapulmonary infections in immunocompetent individuals 7. One of the uncommon sequelae of TB meningitis is septic dural sinus thrombosis as previously reported in a case by Verma et al 8. In another case, extensive calvarial TB causing compression and occlusion of the SSS was reported in a man presenting with a non-healing scalp sinus 9…”

Section: Discussionmentioning

confidence: 75%

Venous sinus thrombosis secondary to tuberculous meningitis: a novel cause of trigeminal neuralgia

Tsimiklis¹,

Gragnaniello

Abou-Hamden

2014

BMJ Case Reports

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A 33-year-old Vietnamese man with a history of superior sagittal sinus thrombosis secondary to tuberculous meningitis presented with severe recurrent trigeminal neuralgia. A complex compensatory cerebral venous drainage system developed, and a varix, in direct contact with the root entry zone of the trigeminal nerve, was the trigger for his pain. The patient's symptoms are presently controlled with a combination of medications for neuropathic pain, however he continues to experience frequent severe exacerbations and may very well require more invasive means to manage his condition in future.

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Section: Discussionmentioning

confidence: 75%

Venous sinus thrombosis secondary to tuberculous meningitis: a novel cause of trigeminal neuralgia

Tsimiklis¹,

Gragnaniello

Abou-Hamden

2014

BMJ Case Reports

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“…7 Despite this high prevalence of TB in India, its association with CVT has been scarcely reported. 8 It should be kept in mind that CVT can also present with altered sensorium and other neurological manifestations. The other important causes for altered mental status in TB are tuberculous meningoencephalitis, tuberculoma, hydrocephalus and metabolic encephalopathies like hyponatremia.…”

Section: Discussion Of Managementmentioning

confidence: 99%

A Rare Case of Pulmonary Tuberculosis Predisposing to Cerebral Venous Thrombosis

Thomas¹,

Vijay²,

Maliekal³

2019

jebmh

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PRESENTATION OF CASEA 26-year old female, nurse by profession, with no significant past medical history and family history, was diagnosed with sputum positive pulmonary tuberculosis at an outside hospital following complaints of fever, cough, and night sweats. She was started on anti-tuberculosis treatment (rifampicin, isoniazid, ethambutol and pyrazinamide), and was on treatment for 15 days at the time of presentation. She presented to our hospital with complaints of two days of altered sensorium, headache, nausea and vomiting. There was no history of photophobia, focal sensory or motor deficits. On the day of admission, she had two episodes of generalised-tonic-clonic seizures. On examination, the patient was drowsy and disoriented with a GCS (Glasgow Coma Score) of 12/15, temperature of 99°F, pulse rate of 84/min and blood pressure of 114/84 mmHg. Physical examination showed the presence of BCG vaccination scar on the left shoulder. There were no signs of meningeal irritation, no focal deficits and optic fundus examination was normal. Physical examination was otherwise unremarkable. InvestigationsThe patient's haemoglobin was 9 g%, total leucocyte count (TLC) was 5200/mm 3, platelet count was 4.2 lakhs/mm 3 , random blood sugar was 88 mg/dL, and erythrocyte sedimentation rate (ESR) was 80 mm at the end of 1 hour. Serum electrolytes, liver and renal function tests were within normal limits. Cerebrospinal fluid (CSF) study did not show any evidence of TB meningitis. CT brain revealed features suspicious of venous infarct and hence an MRI plus MR venogram (MRV) was done which confirmed the diagnosis of cerebral venous thrombosis (Figure 1 and 2). In view of the thrombosis, coagulation profile was assessed and it revealed a PT-INR of 1.2 and aPTT of 38 seconds. The patient's thrombophilia panel showed normal anti-thrombin III, protein C, protein S and factor V levels. Antinuclear antibodies (ANA) and homocysteine levels were normal and antiphospholipid antibodies were not detected.

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“…The postulated mechanisms of CVT in tuberculosis are: Endothelial injury due to the inflammatory response, sluggish venous flow, increased platelet aggregation and release of procoagulant factors. [21] Due to the lack of larger studies, it is difficult to establish if the co-occurrence of these two diseases is due to a chance association or it is causally related. If a patient has clinical features and signs suggestive of chronic meningitis along with the cerebrospinal fluid examination and neuroimaging findings suggesting the presence of TBM; or, if there is evidence of tuberculosis elsewhere, then the suspicion of concomitant TBM should arise in the clinician's mind.…”

Section: What Are the Etiological Factors For Cerebral Venous Thrombomentioning

confidence: 99%

“…Literature search on Medline with the key words of "CVT and tuberculosis" yielded only a few case reports. [19][20][21] Pai et al reported associated tuberculosis as an etiological factor for CVT in 14.3% of patients. [13] But the authors have not commented about the type of tuberculosis (whether it was TBM or pulmonary tuberculosis).…”

Section: What Are the Etiological Factors For Cerebral Venous Thrombomentioning

confidence: 99%

Cerebral venous thrombosis: An Indian perspective

2015

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Cerebral venous thrombosis (CVT) is an uncommon cause of stroke with extremely varied clinical presentations, predisposing factors, imaging findings, and outcomes, and thus can be extremely challenging to diagnose. Accurate and prompt diagnosis of CVT is crucial because timely and appropriate therapy can reverse the disease process and significantly reduce the risk of acute complications and long-term squel. In this article, we have reviewed the epidemiology, causative factors, clinical features, diagnosis and treatment of CVT from an Indian perspective. Over the last decade, a change in trends in the causative factors has been noted from India.

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A rare presentation of cerebral venous sinus thrombosis associated with tubercular meningitis

Cited by 23 publications

References 15 publications

Venous sinus thrombosis secondary to tuberculous meningitis: a novel cause of trigeminal neuralgia

Venous sinus thrombosis secondary to tuberculous meningitis: a novel cause of trigeminal neuralgia

A Rare Case of Pulmonary Tuberculosis Predisposing to Cerebral Venous Thrombosis

Cerebral venous thrombosis: An Indian perspective

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