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Abstract #5184

MRI Features of Stroke in Tuberculous Meningitis: a case report

Patricia Mazwi Maishi1, James Barnacle2,3,4, Azhar Seedat5, and Tessa Kotze1
1Human Biology, University of Cape Town, Cape Town, South Africa, 2Francis Crick Institute, London, United Kingdom, 3Infectious Disease, Imperial College London, London, United Kingdom, 4Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, Cape Town, South Africa, 5Radiology, Groote Schuur Hospital, Cape Town, South Africa

Synopsis

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Motivation: TBM is the most severe form of tuberculosis and often leads to death or neurological sequelae. Inflammation caused by a dysregulated inflammatory response can cause stroke, a frequent cause of morbidity and mortality in TBM.

Goal(s): To accurately identify areas affected by stroke in TBM.

Approach: MRI brain scan was performed on 1.5 Tesla, Skyra scanner equipped with an 20 channel coil and parameters were derived from the following acquisitions: 3D T1-MPRAGE pre- and post-gadolinium enhancement imaging; DWI and ADC map, FLAIR, and GRE.

Results: MRI is reliable in identifying stroke features and the imaging findings were pivotal to prompt treatment of TBM.

Impact: 14-year-old with a left CNVI palsy and lower limb weakness, was admitted due to onset of seizure. Tuberculous meningitis complicated by stroke was diagnosed as the cause. The incidence, consequences and MRI features of TBM are discussed in this report.

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