International Journal of Neurosurgery

Archive

Submit a Manuscript

Publishing with us to make your research visible to the widest possible audience.

Propose a Special Issue

Building a community of authors and readers to discuss the latest research and develop new ideas.

Tuberculosis: A More Than One Pathophysiology to Induce Neurological Disorder

Tuberculosis (TB) is an infectious disease which can infect all body organs including the central nervous system (CNS). TB has a higher mortality rate worldwide and is a frequent cause of neurologic sequelae. Approximately 10% of TB patients also have a CNS involvement. CNS-TB can take several clinical forms; Therefore, this review concentrates on the most prevalent types of CNS-TB because it is one of the most severe forms of extrapulmonary tuberculosis. Tuberculous meningitis is the most common type of CNS tuberculosis. The patient presents with insidious chronic meningitis or acute fulminant meningitis. Hydrocephalus is usually associated, especially in children, Intracranial vasculopathy, which is a serious complication of Tuberculous meningitis that can cause stroke. CNS tuberculomas is a hard-granulomatous mass that is commonly presented with focal neurologic impairments depending on its location, along with symptoms and signs of increased intracranial pressure. Tubercular Brain Abscess and Tuberculous Encephalopathy are uncommon clinical presentations of CNS tuberculosis; they usually affect children and HIV patients. Spinal TB (Pott illness) is a common form of skeletal TB that usually affects the thoracic and lumbar spines; if the cervical spine is affected, potentially fatal neurological consequences can occur. The definitive diagnosis of CNS tuberculosis is usually based on examining the CSF (as with TB meningitis) and being evaluated by neuroimaging are often the two main components of the final diagnosis of CNS tuberculosis (CT, MRI). Empirical anti-tuberculous medication, steroids, and only in exceptional circumstances, surgery, are used to treat patients.

Tuberculosis, Extra-Pulmonary Tuberculosis, Pott’s Disease, Tuberculomas, Tuberculous Meningitis

APA Style

Awad Ahmed Ahmed. (2023). Tuberculosis: A More Than One Pathophysiology to Induce Neurological Disorder. International Journal of Neurosurgery, 7(2), 28-31. https://doi.org/10.11648/j.ijn.20230702.12

ACS Style

Awad Ahmed Ahmed. Tuberculosis: A More Than One Pathophysiology to Induce Neurological Disorder. Int. J. Neurosurg. 2023, 7(2), 28-31. doi: 10.11648/j.ijn.20230702.12

AMA Style

Awad Ahmed Ahmed. Tuberculosis: A More Than One Pathophysiology to Induce Neurological Disorder. Int J Neurosurg. 2023;7(2):28-31. doi: 10.11648/j.ijn.20230702.12

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Global tuberculosis report 2020. Global tuberculosis report 2020. 2020. https://www.who.int/publications-detail-redirect/9789240013131 (accessed 16 Dec2022).
2. tuberculosis (TB). Tuberculosis. 2022. https://www.who.int/news-room/fact-sheets/detail/tuberculosis (accessed 16 Dec2022).
3. Peto HM, Pratt RH, Harrington TA, LoBue PA, Armstrong LR. Epidemiology of extrapulmonary tuberculosis in the United States, 1993–2006. Clinical Infectious Diseases. 2009 Nov 15; 49 (9): 1350-7.
4. Cherian A, Thomas SV. Central nervous system tuberculosis. African health sciences. 2011; 11 (1).
5. Phypers M, Harris T, Power C. CNS tuberculosis: a longitudinal analysis of epidemiological and clinical features. The International Journal of Tuberculosis and Lung Disease. 2006 Jan 1; 10 (1): 99-103.
6. Rock RB, Olin M, Baker C. a, Molitor, TW, Peterson, PK, 2008. Central nervous system tuberculosis: pathogenesis and clinical aspects. Clin. Microbiol. Rev.; 21: 243-61.
7. Duque-Silva A, Robsky K, Flood J, Barry PM. Risk factors for central nervous system tuberculosis. Pediatrics. 2015 Nov; 136 (5): e1276-84.
8. Ayele BA, Amogne W. Central Nervous System Tuberculosis (CNS-TB) in treated HIV-infected adults in Tikur Anbessa Specialized Hospital, Ethiopia: A cross sectional study. Journal of Clinical Tuberculosis and Other Mycobacterial Diseases. 2021 Aug 1; 24: 100252.
9. Berenguer J, Moreno S, Laguna F, Vicente T, Adrados M, Ortega A, González-LaHoz J, Bouza E. Tuberculous meningitis in patients infected with the human immunodeficiency virus. New England Journal of Medicine. 1992 Mar 5; 326 (10): 668-72.
10. Leonard JM. Central nervous system tuberculosis. Microbiology Spectrum. 2017 Mar 10; 5 (2): 5-2.
11. Davis AG, Rohlwink UK, Proust A, Figaji AA, Wilkinson RJ. The pathogenesis of tuberculous meningitis. J Leukoc Biol. 2019; 105 (2): 267-280. doi: 10.1002/JLB.MR0318-102R.
12. Garg RK. Tuberculous meningitis. Acta Neurologica Scandinavica. 2010 Aug; 122 (2): 75-90.
13. Ramzan A, Nayil K, Asimi R, Wani A, Makhdoomi R, Jain A. Childhood tubercular meningitis: an institutional experience and analysis of predictors of outcome. Pediatric Neurology. 2013 Jan 1; 48 (1): 30-5.
14. Kumar A, Mudassir S, Sinha N, Babanrao WB, Ranjan A. Stroke in Tuberculous Meningitis and Its correlation with Magnetic Resonance Angiography Manifestations. Journal of Neurosciences in Rural Practice. 2022 Jul; 13 (03): 417-23.
15. Soni N, Kumar S, Shimle A, Ora M, Bathla G, Mishra P. Cerebrovascular complications in tuberculous meningitis—A magnetic resonance imaging study in 90 patients from a tertiary care hospital. The Neuroradiology Journal. 2020 Feb; 33 (1): 3-16.
16. Marais S, Thwaites G, Schoeman JF, Török ME, Misra UK, Prasad K, Donald PR, Wilkinson RJ, Marais BJ. Tuberculous meningitis: a uniform case definition for use in clinical research. The Lancet infectious diseases. 2010 Nov 1; 10 (11): 803-12.
17. Chan ED, Heifets L, Iseman MD. Immunologic diagnosis of tuberculosis: a review. Tubercle and Lung Disease. 2000 May 1; 80 (3): 131-40.
18. Van Well GT, Paes BF, Terwee CB, Springer P, Roord JJ, Donald PR, van Furth AM, Schoeman JF. Twenty years of pediatric tuberculous meningitis: a retrospective cohort study in the western cape of South Africa. Pediatrics. 2009 Jan; 123 (1): e1-8.
19. Who consolidated guidelines on tuberculosis: Module 5: Management of tuberculosis in children and adolescents [Internet]. World Health Organization. World Health Organization; [cited 2022Dec16]. Available from: https://www.who.int/publications/i/item/9789240046764.
20. Prasad K, Singh MB, Ryan H. Corticosteroids for managing tuberculous meningitis. Cochrane Database of Systematic Reviews. 2016 (4)..
21. Ordonez AA, Maiga M, Gupta S, Weinstein EA, Bishai WR, Jain SK. Novel adjunctive therapies for the treatment of tuberculosis. Current molecular medicine. 2014 Mar 1; 14 (3): 385-95.
22. Kanesen D, Kandasamy R, Wong AS, Tharakan J, Lim CJ, Abdullah JM. Clinical outcome of tuberculous meningitis with hydrocephalus—a retrospective study. The Malaysian Journal of Medical Sciences: MJMS. 2021 Oct; 28 (5): 82.
23. Kemaloglu S, Özkan Ü, Bukte Y, Ceviz A, Özates M. Timing of shunt surgery in childhood tuberculous meningitis with hydrocephalus. Pediatric neurosurgery. 2002; 37 (4): 194-8.
24. Daniel BD, Grace GA, Natrajan M. Tuberculous meningitis in children: Clinical management & outcome. Indian J Med Res. 2019; 150 (2): 117-130. doi: 10.4103/ijmr.IJMR_786_17.
25. Shah IA, Asimi RP, Kawoos Y, Wani M, Sarmast AH. Tuberculomas of the brain with and without associated meningitis: a cohort of 28 cases treated with anti-tuberculosis drugs at a tertiary care centre. International Journal of Contemporary Medical Research. 2016; 3 (12): 3484-7.
26. Nelson CA, Zunt JR. Tuberculosis of the central nervous system in immunocompromised patients: HIV infection and solid organ transplant recipients. Clinical infectious diseases. 2011 Nov 1; 53 (9): 915-26.
27. Gaillard F, Knipe H, Baba Y, et al. Cerebral ring enhancing lesions. Reference article, Radiopaedia.org (Accessed on 12 Dec 2022) https://doi.org/10.53347/rID-6679.
28. Marais S, Roos I, Mitha A, Patel V, Kalincik T, Bhigjee AI. Presentation and outcome of patients with intracranial tuberculoma in a high HIV prevalence setting. The International Journal of Tuberculosis and Lung Disease. 2020 Feb 1; 24 (2): 224-32.
29. Ravindra Kumar Garg, Tuberculosis of the central nervous system, Postgraduate Medical Journal, Volume 75, Issue 881, March 1999, Pages 133–140, https://doi.org/10.1136/pgmj.75.881.133.
30. Ansari MK, Jha S. Tuberculous brain abscess in an immunocompetent adolescent. Journal of Natural Science, Biology, and Medicine. 2014 Jan; 5 (1): 170.
31. Gupta RK, Vatsal DK, Husain N, Chawla S, Prasad KN, Roy R, Kumar R, Jha D, Husain M. Differentiation of tuberculous from pyogenic brain abscesses with in vivo proton MR spectroscopy and magnetization transfer MR imaging. American Journal of Neuroradiology. 2001 Sep 1; 22 (8): 1503-9.
32. Modi M, Garg A. Tuberculosis of central nervous system. Journal of Postgraduate Medicine, Education and Research. 2013 Oct 1; 47 (4): 202.
33. Piquet AL, Cho TA. The clinical approach to encephalitis. Current neurology and neuroscience reports. 2016 May; 16: 1-8.
34. Garg RK, Somvanshi DS. Spinal tuberculosis: a review. The journal of spinal cord medicine. 2011 Sep 1; 34 (5): 440-54.
35. Moon MS. Tuberculosis of spine: current views in diagnosis and management. Asian spine journal. 2014 Feb; 8 (1): 97.
36. Cheung WY, Luk KD. Pyogenic spondylitis. International orthopaedics. 2012 Feb; 36: 397-404.
37. Hussain I, Schmidt FA, Kirnaz S, Wipplinger C, Schwartz TH, Härtl R. MIS approaches in the cervical spine. Journal of Spine Surgery. 2019 Jun; 5 (Suppl 1): S74.