Atypical cause of stroke in an 18 years old female

Authors

  • Md Rashedul Islam Registrar, Department of Neurology, BIRDEM General Hospital, Dhaka
  • Tanbin Rahman Registrar, Medicine, Greenlife Medical College, Dhaka
  • Rumana Habib Assistant Professor, Department of Neurology, BIRDEM General Hospital, Dhaka
  • Aminur Rahman Consultant, Department of Neurology, BIRDEM General Hospital, Dhaka
  • Nirmalendu Bikash Bhowmik Professor, Department of Neurology, BIRDEM General Hospital, Dhaka
  • Md Amirul Haque Professor & Head, Department of Neurology, BIRDEM General Hospital, Dhaka

DOI:

https://doi.org/10.3329/bccj.v4i2.30031

Keywords:

Ischemic stroke, Tuberculous meningitis

Abstract

Central nervous system (CNS) tuberculous meningitis is a progressive disease that presents in many ways. CNS TB is encountered frequently in areas of high prevalence of tuberculosis and dissemination is common. An 18 year old female presented with complaints of headache, low grade fever & double vision. We found cranial nerve palsy & focal neurological signs during examination. Work up revealed cerebral spinal fluid (CSF) study consistent with acute lymphocytic meningitis. Magnetic resonance imaging (MRI) revealed multiple tuberculomas with gadolinium enhancement & cerebral infarction on basal ganglia. Given the characteristic CSF and MRI finding for Tuberculosis (TB), positive MT & choroidal tubercle on fundoscopy, ischemic stroke due to tubercular meningitis is made. The patient showed significant improvement after anti tuberculosis therapy was begun. CNS TB is a treatable disease but can be fatal if not detected or treated. Clinicians should be aware of key clinical features of TB meningitis, and maintain a high level of suspicion when patients present with focal neurological signs.

Bangladesh Crit Care J September 2016; 4 (2): 128-130

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Author Biography

Md Rashedul Islam, Registrar, Department of Neurology, BIRDEM General Hospital, Dhaka



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Published

2016-10-21

How to Cite

Islam, M. R., Rahman, T., Habib, R., Rahman, A., Bhowmik, N. B., & Haque, M. A. (2016). Atypical cause of stroke in an 18 years old female. Bangladesh Critical Care Journal, 4(2), 128–130. https://doi.org/10.3329/bccj.v4i2.30031

Issue

Vol. 4 No. 2 (2016)

Section

Case Reports

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