Cases reported "Tuberculosis, Meningeal"

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1/19. Vascular changes in tuberculous meningoencephalitis.

    Our report refers two cases of tuberculous encephalomeningitis which differ in the course and pathological changes. In case 1 blood vessels showed features of peri, endo-, or panvasculites. In some vessels endothelium proliferation leading to the stenosis or obliteration of the vascular lumen was observed. necrosis was an effect of vessels occlusion. In case 2 many fewer vessel were involved in onflammation process. Vascular changes were also less extensive and were observed more rarely. Tuberculous infection often caused less tissue lesions than vascular changes. Different pathological changes probably depend on the type and virulence of Myobacterium tuberculosis and on the host immune response to the infection.
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ranking = 1
keywords = meningoencephalitis, encephalitis
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2/19. Sporadic tuberculous meningoencephalitis.

    Tuberculous meningoencephalitis in a 24-month-old boy is reported. He contracted the infection from his apparently healthy grandfather with unnoticed pulmonary tuberculosis, as suggested by restriction fragment length polymorphism analysis of the isolated pathogen.
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ranking = 1.25
keywords = meningoencephalitis, encephalitis
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3/19. Fluid-attenuated inversion-recovery imaging of cerebral infarction associated with tuberculous meningitis.

    A 12-month-old girl presented with fever and vomiting. cerebrospinal fluid (CSF) examination revealed an increase of mononuclear cells and mycobacterium tuberculosis. magnetic resonance imaging (MRI) taken two months after the onset showed cerebral infarction in the left basal ganglia, tuberculoma in the interpeduncular cistern and brain atrophy. The infarction was shown as central cystic lesions with surrounding hyperintensity in the fluid-attenuated inversion-recovery (FLAIR) image. The cystic lesions were not differentiated from surrounding lesions in T2 weighted image (T2WI) because both lesions were demonstrated as hyperintensity areas. The hyperintensity lesion shown in FLAIR image may indicate border zone encephalitis. The FLAIR image is more useful than T1 or T2WI to detect the extension of the infarcted area and circumscribed change.
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ranking = 0.012087907476983
keywords = encephalitis
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4/19. Effects of TENS and methylphenidate in tuberculous meningo-encephalitis.

    PRIMARY OBJECTIVE: Beneficial effects of transcutaneous electrical nerve stimulation (TENS) on cognition and behaviour were observed in a child with probable herpes simplex Encephalitis. Based on these positive findings, it was examined in the present case study whether a child who had been diagnosed to suffer from tuberculous meningitis would benefit from TENS. Furthermore, as aggression and overactive behaviour were also prominent clinical symptoms, the effects of methylphenidate were investigated. methods AND PROCEDURES: neuropsychological tests were used to assess attention/concentration and visuospatial and visuoconstructive memory. Behaviour, including the level of activity during 24 hours, was assessed by one observation scale and actigraphy. EXPERIMENTAL INTERVENTIONS: TENS and methylphenidate. MAIN OUTCOMES AND RESULTS: TENS particularly improved overall affective behaviour. methylphenidate appeared to have the opposite effect on cognition and hardly any effect on patient's behaviour. CONCLUSIONS: TENS might improve the patient's behavioural functioning. Pros and cons for treatment effects are discussed.
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ranking = 0.048351629907932
keywords = encephalitis
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5/19. Late clinical manifestation of cerebral tuberculomas in two children with tuberculous meningoencephalitis.

    We report on two children with cerebral tuberculomas leading to late dramatic clinical exacerbation after appropriate antituberculous chemotherapy and high-dose corticosteroids. A 6-year-old girl with tuberculous meningoencephalitis initially fully recovered. However, after 9 months of continuous therapy she presented with acute increased intracranial pressure caused by tuberculomas requiring rapid drainage of CSF. A 16-year-old boy with miliary pulmonary tuberculosis and severe meningoencephalitis had reached a stable condition for more than 10 months although still suffering from a left-dominant spasticity and motor dysphasia. Fifteen months after initiation of therapy he presented with an acute central paralysis of the left facial nerve, progressive hemiplegia, severe ataxia and increasing lethargy caused by a cerebral tuberculoma with a perifocal oedema. Prolonged treatment with antituberculous chemotherapy and high-dose corticosteroids led to complete recovery in the younger patient and marked improvement in the older patient who remains severely handicapped. CONCLUSION: patients with initially successful treatment of central nervous system tuberculosis should undergo an alert follow-up for the development of late cerebral tuberculomas. Treatment should consist of prolonged courses of antituberculous chemotherapy and high-dose corticosteroids.
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ranking = 1.5
keywords = meningoencephalitis, encephalitis
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6/19. Tuberculous meningoencephalitis in hiv-seronegative patients: variety of clinical presentation and impact on diagnostics and treatment.

    Tuberculous meningoencephalitis (TBM), an infrequent disease in Western European countries, shows a wide heterogeneity of clinical symptoms. MATERIAL AND methods: We present 4 patients (age range 42-72 years) with the definite diagnosis of isolated TBM. All patients were hiv-seronegative, only 1 patient was known to be immunoincompetent on admission due to acute myelocytic leukemia; other reasons for immune suppression were detected in 2 other patients (leukemia and idiopathic CD4 T-lymphocytopenia, respectively). RESULTS: The diagnosis of TBM was confirmed in 3 cases by culture from CSF, in 1 case mycobacterium tuberculosis was proven only in tracheal aspirate. In 1 patient M. bovis was found, which is an extremely rare cause of TBM in germany. We report the contributions of different diagnostic tools (CSF analysis, neuroimaging) in reaching the presumptive diagnosis and in monitoring the further course. All patients developed neurological complications despite prompt tuberculostatic treatment. Three of the patients presented a chronic severe loss of consciousness of unclear origin. CONCLUSION: The possible causative relationships of these complications and their impact on the prognosis are discussed.
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ranking = 1.25
keywords = meningoencephalitis, encephalitis
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7/19. Intraventricular rifampicin in severe tuberculous meningo-encephalitis.

    We present a patient acutely ill from severe tuberculous meningo-encephalitis, in whom acute hepatic and renal failure, due to intercurrent septic shock, precluded the administration of full systemic dosage of antituberculous drugs. Daily direct intraventricular administration of 5 mg rifampicin, via a subcutaneous Ommaya reservoir connected to a catheter placed in the right lateral cerebral ventricle, resulted in rapid improvement without neurological sequelae. Intraventricular rifampicin administration for 50 consecutive days was well-tolerated without local or systemic side-effects. In well-selected patients with severe tuberculous meningo-encephalitis, intraventricular rifampicin may safely and highly effectively be added to systemic antituberculous therapy.
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ranking = 0.072527444861898
keywords = encephalitis
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8/19. cerebral infarction and cerebral salt wasting syndrome in a patient with tuberculous meningoencephalitis.

    A 38-year old female with underlying systemic lupus erythematosus was admitted with tuberculous meningoencephalitis. After an initial good response to anti-tuberculous treatment, she developed cerebral infarction and profound hyponatremia. This was due to cerebral salt wasting syndrome, which has only previously been described in 2 cases. The difficulties in diagnosis and management of this case are discussed.
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ranking = 1.25
keywords = meningoencephalitis, encephalitis
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9/19. kluver-bucy syndrome -- an experience with six cases.

    The kluver-bucy syndrome (KBS) is a neurobehavioral syndrome and can be seen in association with a variety of neurological disorders. Case records of 6 patients with KBS seen during a period of 5 years in a university hospital were reviewed. During the study period 6 patients with KBS, aged between 4 and 14 years, were seen. Hyperorality, hypersexuality, and abnormal behavior were the most common manifestations. Of the 6 patients, 5 had recurrent unprovoked seizures. The associated neurological disorders included anoxia-ischemic encephalopthy (2), herpes simplex encephalitis (1), neurocysticercosis (NCC) (1), traumatic brain injury with gliosis (1 case) and tuberculous meningitis (1 case). prognosis was poor in all the patients except in the patient with NCC.
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ranking = 0.012290721182467
keywords = encephalitis, herpes
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10/19. Atypical presentations of tuberculous meningitis--a case report.

    A case of tuberculous meningitis, proved by cerebrospinal fluid (CSF) cultures, is reported due to atypical findings in CSF. This 19-year-old man developed subacute headache and fever for 2 weeks, followed by focal seizure and left hemiparesis. Initial CSF study showed hemorrhagic lymphocytic pleocytosis with mildly elevated protein and normal sugar content, mimicking viral or postinfectious meningoencephalitis. Follow-up CSF studies showed polymorphonuclear pleocytosis. A concomitant bacterial meningoencephalitis was suspected, though repeated CSF cultures did not isolate any bacteria. The activity of adenosine deaminase in CSF was 12 U/L, highly suggestive of tuberculous meningitis. magnetic resonance imaging (MRI) showed only a focal meningoencephalitis in the right lateral frontal cortex. Due to progressive deterioration of the clinical status, umbrella therapy, including antimycobacterial drugs and strong antibiotics were given. At a later time, growth of tubercle bacilli was reported in the CSF cultures. Follow-up study of MRI 4 months later, showed thick abnormal enhancement in the basal cisterns and obstructive hydrocephalus, typical findings of chronic basal meningitis.
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ranking = 0.75
keywords = meningoencephalitis, encephalitis
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