Abstract

Background and Purpose: Neurovascular complications are the main causes of morbidity and mortality in tuberculous meningitis (TBM). However, there is paucity of data available on the spectrum of MRA abnormalities in TBM. We undertook this study to assess the spectrum of abnormalities involving the intracranial arteries in TBM by non-enhanced three- dimensional time-of-flight (3D-TOF) MRA and to determine if there is any relationship between abnormal angiogram and the disease outcome.

Materials and Methods: Twenty-five patients of TBM had clinical, laboratory, MRI and non-enhanced TOF MRA evaluation. Additionally, 11 patients underwent CT scans during follow up. The spectrum of abnormalities in MRA was evaluated. All patients were evaluated for the clinical outcome using the Glasgow outcome score (GOS) at discharge, 3 months and 6 months.

Results: Infarcts were noted in 16 patients, seen predominantly in the distribution of lateral lenticulostriate artery territory (68.75%). 64% patients had abnormal angiograms. MCA was most commonly involved (93.75%) followed by PCA (25%), supraclinoid ICA (18.75%) and ACA (6.25%). Arteries and their segments around the circle of Willis were most commonly involved. The MRA abnormalities include focal stenosis (60%), irregular segmental stenosis (12%), collateral formation (8%) and complete occlusion (4%). Poor outcome (GOS of 1, 2 and 3) was significantly found in patients with abnormal angiograms (p = 0.014).

Conclusion: Non-enhanced 3D-TOF-MRA is useful to assess the spectrum of angiographic abnormalities early in the course of illness. It can be used to predict the outcome of the disease in relation to vascular complications.

Keywords: Non-Enhanced; 3D-TOF-MRA; Tuberculous; Angiographic

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Citation

Citation: Chatterjee P., et al. “Non-Enhanced 3D-TOF-MRA Evaluation in Tuberculous Meningitis and Correlation of Angiographic Abnormalities with Clinical Outcome". Acta Scientific Neurology 5.6 (2022): 52-61.

Copyright

Copyright: © 2022 Chatterjee P., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.