Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Nehru Hospital, Sector 12, Chandigarh, 160012, India.
Department of Radiodiagnosis, Postgraduate Institute of Medical Education & Research, Nehru Hospital, Sector 12, Chandigarh, 160012, India.
Biomark Med. 2024;18(8):407-417. doi: 10.1080/17520363.2024.2347194. Epub 2024 May 17.
Tuberculous meningitis (TBM) often causes cerebral infarction, but its predictive factors are not well understood. Patients aged ≥13 years admitted with TBM were enrolled prospectively. Cerebral infarction was diagnosed using magnetic resonance imaging. Of 186 patients, 80 (43%) had infarction. Most infarctions were multiple and located in the cortical areas, basal ganglia and subcortical regions. Independent predictors of infarction at admission included high blood pressure, short illness duration, low Glasgow coma scale and hydrocephalus. Neuroimaging inflammation signs, cerebrospinal fluid analysis abnormalities and pre-existing cardiovascular risks did not predict infarction. In-hospital mortality was higher in TBM with infarction, particularly in those with advanced TBM (stage 3). Baseline parameters of raised intracranial pressure predict cerebral infarction in TBM.
结核性脑膜炎（TBM）常引起脑梗死，但其预测因素尚不清楚。前瞻性纳入年龄≥13 岁的 TBM 住院患者。采用磁共振成像诊断脑梗死。186 例患者中，80 例（43%）有梗死。大多数梗死灶为多发性，位于皮质区、基底节区和皮质下区。入院时脑梗死的独立预测因素包括高血压、病程短、格拉斯哥昏迷量表评分低和脑积水。神经影像学炎症征象、脑脊液分析异常和既往心血管风险并不能预测梗死。伴有梗死的 TBM 患者的住院死亡率更高，尤其是 TBM 晚期（3 期）患者。颅内压升高的基线参数可预测 TBM 中的脑梗死。
