A Combination of Moyamoya Pattern and Cerebral Venous Sinus Thrombosis: A Case of Tubercular Vasculopathy

Moyamoya vasculopathy, arising secondary to tubercular meningitis (TBM) is unusual. There have also been a few reports of cerebral venous sinus thrombosis (CVST) in TBM. A case of TBM, complicated simultaneously by Moyamoya syndrome and CVST, is being presented here. A 1-year-old girl presented with...

Full description

Saved in:
Bibliographic Details
Published in:Journal of tropical pediatrics (1980) 2015-10, Vol.61 (5), p.393-396
Main Authors: Kumar, Ranjith M, Saini, Lokesh, Kaushik, Jaya Shankar, Chakrabarty, Biswaroop, Kumar, Atin, Gulati, Sheffali
Format: Article
Language:English
Subjects:
Anticoagulants - administration & dosage
Anticoagulants - therapeutic use
Antitubercular Agents - administration & dosage
Antitubercular Agents - therapeutic use
Female
Heparin - administration & dosage
Heparin - therapeutic use
Humans
Infant
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Middle Cerebral Artery
Moyamoya Disease - diagnosis
Mycobacterium
Sinus Thrombosis, Intracranial - diagnosis
Sinus Thrombosis, Intracranial - drug therapy
Treatment Outcome
Tuberculosis, Meningeal - diagnosis
Tuberculosis, Meningeal - drug therapy
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Moyamoya vasculopathy, arising secondary to tubercular meningitis (TBM) is unusual. There have also been a few reports of cerebral venous sinus thrombosis (CVST) in TBM. A case of TBM, complicated simultaneously by Moyamoya syndrome and CVST, is being presented here. A 1-year-old girl presented with febrile encephalopathy, vomiting, seizures and left hemiparesis. Cerebrospinal fluid analysis was suggestive of TBM. Extensive infarcts were noted in the magnetic resonance imaging, involving right middle cerebral artery (MCA), anterior cerebral artery and the left MCA. Magnetic resonance venogram revealed left transverse venous sinus thrombosis and magnetic resonance angiography showed bilateral moyamoya pattern of arteriopathy. Patient was started on antitubercular therapy and low molecular weight heparin. Early vascular involvement affecting both arterial and venous structures has not hitherto been reported in CNS tuberculosis. Early recognition of secondary complications of CNS tuberculosis is crucial to prevent the morbidity and mortality associated with TBM.
ISSN:0142-6338
1465-3664
DOI:10.1093/tropej/fmv036