PDF(Pubmed)
Abstract：
BACKGROUND: Tuberculous meningitis (TBM), complicated with cerebral venous thrombosis (CVT), has been sparsely reported and needs to be investigated further.
METHODS: Among those with tuberculous meningitis in Haihe Hospital, Tianjin University, 3 patients with venous sinus thrombosis were identified retrospectively. \"Tuberculous meningitis\" and \"cerebral venous thrombosis\" were used as keywords, and the retrieved literature was summarized and analyzed. Our data were combined with previously reported case data to describe this new condition.
RESULTS: Among 28 patients with a median onset age of 31 years for TBM, 17 were females. The manifestations were fever, headache, and seizure. Magnetic resonance imaging (MRI) venography showed that the most common site of venous sinus thrombosis involved superior sagittal sinus, left transverse sinus, left sigmoid sinus, cavernous sinus, and straight sinus. The abnormalities found on MRI include hydrocephalus, exudates, hemorrhage, meningeal enhancement, infarction, and tuberculoma. In the acute phase, all patients received standard anti-TB treatment, and 14/28 patients received anticoagulant treatment. The mortality rate of these patients was 17.9%, and 21/28 (75%) became functionally independent.
CONCLUSIONS: CVT is one of the rare complications of TMB and must be considered a differential diagnosis in patients with TBM who show poor clinical features and/or develop new neurological signs.
METHODS: Among those with tuberculous meningitis in Haihe Hospital, Tianjin University, 3 patients with venous sinus thrombosis were identified retrospectively. \"Tuberculous meningitis\" and \"cerebral venous thrombosis\" were used as keywords, and the retrieved literature was summarized and analyzed. Our data were combined with previously reported case data to describe this new condition.
RESULTS: Among 28 patients with a median onset age of 31 years for TBM, 17 were females. The manifestations were fever, headache, and seizure. Magnetic resonance imaging (MRI) venography showed that the most common site of venous sinus thrombosis involved superior sagittal sinus, left transverse sinus, left sigmoid sinus, cavernous sinus, and straight sinus. The abnormalities found on MRI include hydrocephalus, exudates, hemorrhage, meningeal enhancement, infarction, and tuberculoma. In the acute phase, all patients received standard anti-TB treatment, and 14/28 patients received anticoagulant treatment. The mortality rate of these patients was 17.9%, and 21/28 (75%) became functionally independent.
CONCLUSIONS: CVT is one of the rare complications of TMB and must be considered a differential diagnosis in patients with TBM who show poor clinical features and/or develop new neurological signs.
摘要：
背景：结核性脑膜炎（TBM），并发脑静脉血栓形成（CVT），报告很少，需要进一步调查。
方法：在海河医院的结核性脑膜炎患者中，天津大学,回顾性分析3例静脉窦血栓形成患者。以“结核性脑膜炎”和“脑静脉血栓形成”为关键词，并对检索到的文献进行了总结和分析。我们的数据与以前报道的病例数据相结合来描述这种新情况。
结果：在28位中位发病年龄为31岁的TBM患者中，17是女性。表现是发烧，头痛,和癫痫。磁共振成像（MRI）静脉造影显示，静脉窦血栓形成的最常见部位涉及上矢状窦，左横窦,左乙状窦,海绵窦,和直窦。MRI发现的异常包括脑积水,分泌物,出血,脑膜增强,梗塞,和结核瘤.在急性期,所有患者均接受标准抗结核治疗,14/28例患者接受抗凝治疗。这些患者的死亡率为17.9%,21/28（75％）变得功能独立。
结论：CVT是TMB的罕见并发症之一，对于临床特征差和/或出现新的神经系统体征的TBM患者，必须考虑其鉴别诊断。
方法：在海河医院的结核性脑膜炎患者中，天津大学,回顾性分析3例静脉窦血栓形成患者。以“结核性脑膜炎”和“脑静脉血栓形成”为关键词，并对检索到的文献进行了总结和分析。我们的数据与以前报道的病例数据相结合来描述这种新情况。
结果：在28位中位发病年龄为31岁的TBM患者中，17是女性。表现是发烧，头痛,和癫痫。磁共振成像（MRI）静脉造影显示，静脉窦血栓形成的最常见部位涉及上矢状窦，左横窦,左乙状窦,海绵窦,和直窦。MRI发现的异常包括脑积水,分泌物,出血,脑膜增强,梗塞,和结核瘤.在急性期,所有患者均接受标准抗结核治疗,14/28例患者接受抗凝治疗。这些患者的死亡率为17.9%,21/28（75％）变得功能独立。
结论：CVT是TMB的罕见并发症之一，对于临床特征差和/或出现新的神经系统体征的TBM患者，必须考虑其鉴别诊断。
