Concurrent cerebral infarction and intracranial tuberculoma induced by the carotid plaque complicated with miliary tuberculosis

Acta Neurochir (Wien). 2023 Mar;165(3):647-650. doi: 10.1007/s00701-023-05489-7. Epub 2023 Jan 10.

Abstract

Cerebrovascular complications of central nervous system tuberculosis (TB) are predictors of poor prognosis and adverse outcomes. These complications are mainly intracranial arterial involvement, with occasional venous involvement. Here, we present a 67-year-old woman with concurrent cerebral infarction and intracranial tuberculoma induced by the carotid plaque complicated by miliary tuberculosis. Mycobacterium tuberculosis was observed on the luminal side of the carotid plaques in pathological specimens. Treatment with anti-TB drugs alone would likely not cure the patient, as M. tuberculosis would continue to disseminate. Endarterectomy could directly remove the embolic source, and a complete cure was achieved.

Keywords: Carotid artery stenosis; Carotid endarterectomy; Cerebral infarction; M. tuberculosis; Tuberculoma; Tuberculous meningitis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antitubercular Agents / therapeutic use
  • Cerebral Infarction
  • Female
  • Humans
  • Tuberculoma* / complications
  • Tuberculoma* / drug therapy
  • Tuberculoma, Intracranial* / complications
  • Tuberculoma, Intracranial* / drug therapy
  • Tuberculosis, Miliary* / complications
  • Tuberculosis, Miliary* / drug therapy

Substances

  • Antitubercular Agents