IJMDC. 2021; 5(1): 399-402

Cerebral venous sinus thrombosis associated with tuberculous meningitis: a case report and review of the literature

Authors: Ala Alkharaan, Abdulrahman Alfawzan, Naser D. Alotaibi, Makki Almuntashri.

ABSTRACT

Background: Central nervous system tuberculosis (TB) has a dismal prognosis with higher rates of mortality and neurological deficits. Few reported cases showed that the TB meningitis was associated with cerebral sinus venous thrombosis (CSVT). In this case report, the clinical course, diagnostic challenges, and management of CSVT associated with TB meningitis is presented. Case Presentation: A 28-year-old female presented with headache, vomiting, altered sensorium, and Glasgow Comma Scale of 11. Non-enhanced computed tomography (CT) of the head and CT venography with contrast showed a filling defect within the proximal part of the left internal jugular vein just prior to left sigmoid sinus indicating thrombosis. Brain magnetic resonance imaging (MRI) confirmed the thrombosis of the left jugular vein. Cerebrospinal fluid (CSF) analysis showed only a moderate elevation of white blood cells (WBCs) with negative culture for organisms. No improvement after starting empirical antibiotics and acyclovir was observed. Due to the exclusion of other infections, the absence of other established risk factors of CSVT, CSF, and imaging findings that was consistent with tuberculous meningitis (TBM), and a positive history of TB sick contact; anti-TB therapy was initiated, which showed significant improvement that confirmed the diagnosis of TBM. Conclusion: A case of CSVT secondary to TBM was presented. Since clinical examination alone might not be sufficient to solve such a diagnostic dilemma, a multidisciplinary approach including radiologists, neurologists, and infectious specialists is warranted to promote proper awareness, detection, and management of CVST associated TB.

Keywords:
Tuberculous meningitis, cerebral sinus venous thrombosis, case report


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Cerebral venous sinus thrombosis associated with tuberculous meningitis: a case report and review of the literature


Authors
Ala Alkharaan
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
PubMed articlesGoogle scholar articles

Abdulrahman Alfawzan
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Naser D Alotaibi
Neurology, Internal Medicine Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs. King Abdullah International Medical Research Center. King Saud bin Abdulaziz University for Health Sciences. Riyadh, Saudi Arabia
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Makki Almuntashri
Neuroradiology, Medical Imaging Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs. King Abdullah International Medical Research Center. King Saud bin Abdulaziz University for Health Sciences. Riyadh, Saudi Arabia
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Correspondence to:
. Ala Alkharaan, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 66alaa66@gmail.com

Publication history
Received 02 Nov 2020
Accepted 16 Nov 2020
Published online 14 Dec 2020
Published in print 11 Jan 2021

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Pubmed Style

Alkharaan A, Alfawzan A, Alotaibi ND, Almuntashri M. Cerebral venous sinus thrombosis associated with tuberculous meningitis: a case report and review of the literature. IJMDC. 2021; 5(1): 399-402. doi:10.24911/IJMDC.51-1604320101


Web Style

Alkharaan A, Alfawzan A, Alotaibi ND, Almuntashri M. Cerebral venous sinus thrombosis associated with tuberculous meningitis: a case report and review of the literature. http://www.ijmdc.com/?mno=24849 [Access: February 25, 2021]. doi:10.24911/IJMDC.51-1604320101


AMA (American Medical Association) Style

Alkharaan A, Alfawzan A, Alotaibi ND, Almuntashri M. Cerebral venous sinus thrombosis associated with tuberculous meningitis: a case report and review of the literature. IJMDC. 2021; 5(1): 399-402. doi:10.24911/IJMDC.51-1604320101


Vancouver/ICMJE Style

Alkharaan A, Alfawzan A, Alotaibi ND, Almuntashri M. Cerebral venous sinus thrombosis associated with tuberculous meningitis: a case report and review of the literature. IJMDC. (2021), [cited February 25, 2021]; 5(1): 399-402. doi:10.24911/IJMDC.51-1604320101


Harvard Style

Alkharaan, A., Alfawzan, . A., Alotaibi, . N. D. & Almuntashri, . M. (2021) Cerebral venous sinus thrombosis associated with tuberculous meningitis: a case report and review of the literature. IJMDC, 5 (1), 399-402. doi:10.24911/IJMDC.51-1604320101


Turabian Style

Alkharaan, Ala, Abdulrahman Alfawzan, Naser D. Alotaibi, and Makki Almuntashri. 2021. Cerebral venous sinus thrombosis associated with tuberculous meningitis: a case report and review of the literature. International Journal of Medicine in Developing Countries, 5 (1), 399-402. doi:10.24911/IJMDC.51-1604320101


Chicago Style

Alkharaan, Ala, Abdulrahman Alfawzan, Naser D. Alotaibi, and Makki Almuntashri. "Cerebral venous sinus thrombosis associated with tuberculous meningitis: a case report and review of the literature." International Journal of Medicine in Developing Countries 5 (2021), 399-402. doi:10.24911/IJMDC.51-1604320101


MLA (The Modern Language Association) Style

Alkharaan, Ala, Abdulrahman Alfawzan, Naser D. Alotaibi, and Makki Almuntashri. "Cerebral venous sinus thrombosis associated with tuberculous meningitis: a case report and review of the literature." International Journal of Medicine in Developing Countries 5.1 (2021), 399-402. Print. doi:10.24911/IJMDC.51-1604320101


APA (American Psychological Association) Style

Alkharaan, A., Alfawzan, . A., Alotaibi, . N. D. & Almuntashri, . M. (2021) Cerebral venous sinus thrombosis associated with tuberculous meningitis: a case report and review of the literature. International Journal of Medicine in Developing Countries, 5 (1), 399-402. doi:10.24911/IJMDC.51-1604320101


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