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结核性脑膜炎与皮质静脉血栓形成:一种罕见但可能致命的组合——病例报告及文献综述

Tubercular meningitis and cortical venous thrombosis: A rare but potentially lethal combination-A case report and literature review.

作者信息

Mehta Kahan, Chandrani Naazmin, Shah Ishani, Mehta Samir, Omar Mohamed A

机构信息

Department of Internal Medicine GMERS Medical College, and Hospital Vadodara India.

Department of General Medicine Baroda Medical College Vadodara India.

出版信息

Clin Case Rep. 2023 Aug 28;11(9):e7841. doi: 10.1002/ccr3.7841. eCollection 2023 Sep.

Abstract

KEY CLINICAL MESSAGE

Cortical venous thrombosis is a rare but severe complication of TBM that requires a high index of suspicion for early diagnosis. The treatment of CVT in TBM is based on anticoagulant therapy, which is known to improve the outcomes of the patients.

ABSTRACT

The case report describes an 18-year-old male in India with symptoms of tubercular meningitis complicated by cortical venous thrombosis. Tubercular meningitis is a rare but severe form of meningitis caused by tuberculosis bacteria and is a significant public health concern in India. The patient presented to the emergency department with a history of fever, headache, and vomiting for the past month, with a positive test. The patient was started on standard antitubercular therapy and was diagnosed with cortical venous thrombosis via an MRI scan. Treatment included antitubercular therapy, anticoagulation therapy, dexamethasone, and antiemetic drugs. The patient's symptoms improved over 2 weeks of therapy. The case highlights the importance of early detection, treatment, and prevention strategies, such as the National Tuberculosis elimination program, in controlling the spread of tuberculosis in India. It also emphasizes the importance of close monitoring for complications in patients with tubercular meningitis, such as cortical venous thrombosis, which can be life-threatening.

摘要

关键临床信息

皮质静脉血栓形成是结核性脑膜炎罕见但严重的并发症,早期诊断需要高度怀疑。结核性脑膜炎中皮质静脉血栓形成的治疗基于抗凝治疗,已知该治疗可改善患者预后。

摘要

该病例报告描述了一名18岁印度男性,患有结核性脑膜炎合并皮质静脉血栓形成的症状。结核性脑膜炎是由结核杆菌引起的一种罕见但严重的脑膜炎形式,在印度是一个重大的公共卫生问题。该患者因过去一个月发热、头痛和呕吐病史就诊于急诊科,检测呈阳性。患者开始接受标准抗结核治疗,并通过磁共振成像扫描诊断为皮质静脉血栓形成。治疗包括抗结核治疗、抗凝治疗、地塞米松和止吐药物。经过2周治疗,患者症状改善。该病例凸显了早期发现、治疗和预防策略(如国家结核病消除计划)在控制印度结核病传播方面的重要性。它还强调了对结核性脑膜炎患者密切监测并发症(如可能危及生命的皮质静脉血栓形成)的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfc7/10462772/8f8fe1324522/CCR3-11-e7841-g003.jpg

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