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Abstract Details

Acute Ischemic Stroke In Patients With Tuberculous Meningitis
Infectious Disease
P8 - Poster Session 8 (11:45 AM-12:45 PM)
4-004
To study the clinical profile of acute stroke in patients with tuberculous meningitis(TBM) and its outcome.
In tuberculous meningitis, the exudates surround the vessels which lead to periarteritis and may progress to pan-arteritis causing occlusion of the blood vessel leading to stroke.
This study was carried out at Sri Ramachandra Medical Centre from 2019-2021. Data was collected retrospectively from the medical records from 2019-2020 and prospectively from patients admitted in our hospital from 2020-2021. Patients were diagnosed as TBM based on their clinical presentation, MRI features and CSF reports. Clinical features like fever, headache, vomiting, altered consciousness, focal deficit, neck stiffness, seizure, cranial nerve palsy and Glasgow coma scale(GCS) were recorded. Patients were grouped into TBM stages 1, 2 and 3. CSF analysis was done for all patients which included WBC count, differential count, sugar, protein, adenosine deaminase(ADA) and gene xpert(CBNAAT).
Among 36 patients in the study, 26(72%) were males. 16/36(44%) of patients with TBM developed a stroke. In our study, 7/16(44%) of TBM-related stroke patients presented with seizure. Patients with stroke presented with lower GCS(mean 11) compared to patients without stroke(mean 13). 11/16(69%) patients presented with stroke at the time of diagnosis of TBM, 5/16(31%) had a delayed presentation of stroke(mean 27days). CSF protein was higher in patients with TBM-related stroke compared to patients without stroke(mean 252 vs 174mg/dl, respectively). Patients with stroke presented with a higher TBM stage. In patients with TBM-related infarcts, outcome was poor when compared to patients without stroke(mean modified Rankin scale 3.91 vs 2.45, respectively).

In our study, 44% of patients with TBM developed stroke. Patients with TBM-related infarcts were more likely to present with seizure, a lower GCS and higher TBM stage when compared to patients without stroke. Stroke in tuberculous meningitis leads to a significantly worse outcome.
Authors/Disclosures
Akshay Deepak, MD
PRESENTER 		Dr. Deepak has nothing to disclose.
Shankar Venkatasubramanian Dr. Venkatasubramanian has nothing to disclose.