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Review
. 2015 Dec 29;6(42):45005-9.
doi: 10.18632/oncotarget.6528.

Cerebral hemorrhage due to tuberculosis meningitis: a rare case report and literature review

Hai Zou  1 , Ke-Hua Pan  2 , Hong-Ying Pan  1 , Dong-Sheng Huang  3 , Ming-Hua Zheng  4   5
Affiliations
Review

Cerebral hemorrhage due to tuberculosis meningitis: a rare case report and literature review

Hai Zou et al. Oncotarget. .

Abstract

Tuberculosis (TB) is a common disease to threaten human health. TB of the central nervous system (CNS) is rare but the most serious type of systemic TB because of its high mortality rate, serious neurological complications and sequelae. In this case report, we describe a woman who presented with walking instability, intracerebral hemorrhage and leptomeningeal enhancement due to tuberculosis meningitis. The patient had no significant medical history and the initial clinical symptoms were walking instability. On analysis, the cerebrospinal fluid was colorless and transparent, the pressure was more than 400 mm H2O, there was lymphocytic pleocytosis, increased protein, and decreased glucose levels present. No tuberculosis or other bacteria were detected. The patient's brain computed tomography image showed intra-cerebral hemorrhage (ICH) and contrast magnetic resonance imaging showed ICH in the right frontal lob, and leptomeningeal enhancement. CNS TB is rare but has a high mortality rate. As this disease has no unique characteristics at first presentation such as epidemiology and obvious clinical manifestation, a diagnosis of CNS TB remains difficult.

Keywords: central nervous system; intracerebral hemorrhage; leptomeningeal enhancement; tuberculosis meningitis.

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Conflict of interest statement

CONFLICTS OF INTEREST

There is no conflict of interest

Figures

Figure 1
Figure 1. Noncontrast brain computed tomography shows a hematoma (arrow) in the right frontal lobe
Figure 2
Figure 2. Sagittal brain magnetic resonance images
A. T2-weighted magnetic resonance imaging shows a hematoma (arrow head) in the frontal lobe and cerebral gyrus swelling (arrows); B. T1-weighted magnetic resonance imaging with contrast shows abnormal leptomeningeal enhancement (arrows).
Figure 3
Figure 3. Magnetic resonance angiography showed no cerebral amyloid angiopathy, arteriovenous malformation and aneurysm
See this image and copyright information in PMC

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