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Abstract Details

Pattern of Ischemic Stroke and Magnetic Resonance Angiography in Tuberculous Meningitis
Infectious Disease
Infectious Disease Posters (7:00 AM-5:00 PM)
055
The objective of this study was to evaluate pattern of ischemic stroke and look for vasculitic changes in patients of ischemic stroke in Magnetic resonance angiography. 
Tuberculous meningitis (TBM) is one of the most dreaded forms of extra-pulmonary tuberculosis (TB). It constitutes about 10% of all TB cases and accounts for 40% of the mortality due to TB in developing countries. Stroke is a known complication of TBM. Vasculitis of the large intracranial vessels traversing the basal exudates is common at the base of brain
This was a prospective observational study from tertiary care hospital between September 2018 and September 2020. Diagnostic criteria for TBM were based according to standard case definition published in 2010. Neuroimaging was performed and findings of cerebral infarction and vasculitis were recorded. 
One hundred twenty TBM patients were recruited of which 46 patient had stroke. Median age was 25.5 years (9-64 years) of which 39.1% were women. Median duration of illness to presentation was 45 days (45-360 days). 54.3% of the person had stage III disease. Basal ganglia infarction were present in 54.3%, cortical in 43.5%, thalamic in 34.8%, brainstem in 21.7% and cerebellar in 6.5% of patients. Stroke was multiple in 22 (48.8%) patients. Cerebral Magnetic resonance angiography (MRA) showed abnormality in 30 (65.2%), with involvement of Middle cerebral artery (MCA) in 39.1% (n=18), Anterior cerebral artery in 21.7% (n=10) and Posterior cerebral artery in 13% (n=6) persons. M1 segment was commonly involved in MCA, with occlusion and/or stenosis being most common findings on MRA.
About more than one-third of patients with TBM had ischemic stroke and about two-third of them had vasculitis. Most common site of infraction was basal ganglia and M1 segment of MCA being involved more frequently.
Authors/Disclosures
Sanaullah Mudassir, MD, MBBS (Indira Gandhi Institute of Medical Science)
PRESENTER 		Dr. Mudassir has nothing to disclose.
Abhay Ranjan Abhay Ranjan has nothing to disclose.
No disclosure on file
Ashok Kumar, MD (Indira Gandhi Institute of Medical Sciences, Patna) Dr. Kumar has nothing to disclose.