Muraoka Shinsuke, Oguri Takuya, Kimura Risa, Sakurai Keita, Suzuki Yasuhiko, Shimizu Hiroyuki, Shinoda Satoshi, Koketsu Naoki, Araki Yoshio, Saito Ryuta
Department of Neurosurgery, Kariya Toyota General Hospital, Sumiyoshi Cho 5-15, Kariya, Aichi, Japan.
Department of Neurosurgery, Tosei General Hospital, Nishi-Oiwake Cho 160, Seto, Aichi, Japan.
Acta Neurochir (Wien). 2023 Mar;165(3):647-650. doi: 10.1007/s00701-023-05489-7. Epub 2023 Jan 10.
Cerebrovascular complications of central nervous system tuberculosis (TB) are predictors of poor prognosis and adverse outcomes. These complications are mainly intracranial arterial involvement, with occasional venous involvement. Here, we present a 67-year-old woman with concurrent cerebral infarction and intracranial tuberculoma induced by the carotid plaque complicated by miliary tuberculosis. Mycobacterium tuberculosis was observed on the luminal side of the carotid plaques in pathological specimens. Treatment with anti-TB drugs alone would likely not cure the patient, as M. tuberculosis would continue to disseminate. Endarterectomy could directly remove the embolic source, and a complete cure was achieved.
中枢神经系统结核（TB）的脑血管并发症是预后不良和不良结局的预测指标。这些并发症主要是颅内动脉受累，偶尔也有静脉受累。在此，我们报告一名67岁女性，并发脑梗死和由颈动脉斑块并发粟粒性结核引起的颅内结核瘤。病理标本中在颈动脉斑块的管腔侧观察到结核分枝杆菌。仅用抗结核药物治疗可能无法治愈该患者，因为结核分枝杆菌会继续播散。动脉内膜切除术可以直接去除栓子来源，从而实现了完全治愈。
