Original ArticlePredictors of Stroke and Its Significance in the Outcome of Tuberculous Meningitis
Section snippets
Inclusion Criteria
Patients with TBM diagnosed on the basis of clinical, cerebrospinal fluid (CSF), and radiologic criteria were included. Investigations done in this study are routine in the management of TBM and are approved by our institutional hospital information service. The diagnosis of TBM was based on clinical, CT or MRI scan, and CSF criteria. The essential criteria included presence of meningitic symptoms comprising fever, headache, and vomiting for 2 weeks or more where malaria and septic and fungal
Results
There were 122 patients with TBM whose median age was 32 (range 4-82) years; 7 were children (<12 years) and 41 were older than 40 years. In all, 58 were female. The median duration of illness on admission to our institute was 8 months. Before admission to our institute, 76 patients were receiving antitubercular treatment for a median duration of 30 (2-120) days. A total of 55 patients had stroke during the course of illness and 67 did not. Sixteen patients developed infarct within the first
Discussion
In this study, 45% of patients with TBM had stroke, and stroke was associated with poor outcome at 3 months but not at 6 months. The frequency of stroke in TBM was reported in 28% to 50%.8, 13, 16, 17, 18 This wide variation in the frequency of infarction in TBM may be caused by differences in patient population and methodology. In our study, the diagnosis of stroke was based on MRI findings as the focal weakness may have insidious course in the background of protean manifestations of TBM.
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