Conduction Aphasia as Initial Manifestation of Tuberculous Meningitis

Abstract

Conduction aphasia being the arcuate fasciculus of the site of structural injury is a speech disorder characterized by fluent, spontaneous speech and paraphasias, intact auditory comprehension, and limited repetition. One of the causes of stroke in young adults is the Mycobacterium tuberculosis (MTB) infection, which may cause cerebral ischemia secondary to artery obliteration. In this case report, we present a previously healthy 24-year-old woman that presented with a sudden onset of aphasia; MTB was identified as the etiological agent. Tuberculous meningitis (TBM) has a wide range of clinical manifestations with aphasia being one of the rarest forms of initial presentation.

Keywords: aphasia; conduction aphasia; mycobacterium tuberculosis; stroke; tuberculous meningitis.

Figure 1. Case magnetic resonance image (MRI)

(A) Axial MRI in FLAIR sequence showing a left temporal hyperintense lesion of the white matter in the left temporal lobe. (B) Coronal FLAIR sequence with inferior temporal hyperintense lesion of the white matter. (C) Axial T2-weighted sequence with left temporal hyperintensity. (D) Axial contrast-enhanced T1-weighted sequence showing nodular enhancing lesions on the cerebellum. (E) Axial contrast-enhanced T1-weighted sequence with cortical and nodular enhancing lesions in the left temporal lobe. (F) Axial contrast-enhanced T1-weighted sequence showing cortical nodular enhancing lesions. FLAIR: fluid-attenuated inversion recovery.