Predicting cerebral infarction in tuberculous meningitis and its prognostic significance

IF 1.9 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Asha Aggrohia, Vikas Bhatia, Atul Saroch, Ashok Kumar Pannu
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Abstract

Aim: Tuberculous meningitis (TBM) often causes cerebral infarction, but its predictive factors are not well understood. Methods: Patients aged ≥13 years admitted with TBM were enrolled prospectively. Cerebral infarction was diagnosed using magnetic resonance imaging. Results: Of 186 patients, 80 (43%) had infarction. Most infarctions were multiple and located in the cortical areas, basal ganglia and subcortical regions. Independent predictors of infarction at admission included high blood pressure, short illness duration, low Glasgow coma scale and hydrocephalus. Neuroimaging inflammation signs, cerebrospinal fluid analysis abnormalities and pre-existing cardiovascular risks did not predict infarction. In-hospital mortality was higher in TBM with infarction, particularly in those with advanced TBM (stage 3). Conclusion: Baseline parameters of raised intracranial pressure predict cerebral infarction in TBM.

结核性脑膜炎脑梗塞的预测及其预后意义
目的:结核性脑膜炎(TBM)常导致脑梗死,但其预测因素尚不十分清楚。研究方法对年龄≥13 岁的 TBM 患者进行前瞻性登记。使用磁共振成像诊断脑梗塞。结果在 186 名患者中,80 人(43%)患有脑梗塞。大多数梗死为多发性,位于皮质区、基底节区和皮质下区。入院时脑梗塞的独立预测因素包括高血压、病程短、格拉斯哥昏迷量表低和脑积水。神经影像炎症体征、脑脊液分析异常和原有的心血管风险并不能预测脑梗塞。有梗死的 TBM 患者的院内死亡率较高,尤其是晚期 TBM 患者(3 期)。结论颅内压升高的基线参数可预测 TBM 脑梗死。
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来源期刊
Biomarkers in medicine
Biomarkers in medicine 医学-医学:研究与实验
CiteScore
3.80
自引率
4.50%
发文量
86
审稿时长
6-12 weeks
期刊介绍: Biomarkers are physical, functional or biochemical indicators of physiological or disease processes. These key indicators can provide vital information in determining disease prognosis, in predicting of response to therapies, adverse events and drug interactions, and in establishing baseline risk. The explosion of interest in biomarker research is driving the development of new predictive, diagnostic and prognostic products in modern medical practice, and biomarkers are also playing an increasingly important role in the discovery and development of new drugs. For the full utility of biomarkers to be realized, we require greater understanding of disease mechanisms, and the interplay between disease mechanisms, therapeutic interventions and the proposed biomarkers. However, in attempting to evaluate the pros and cons of biomarkers systematically, we are moving into new, challenging territory. Biomarkers in Medicine (ISSN 1752-0363) is a peer-reviewed, rapid publication journal delivering commentary and analysis on the advances in our understanding of biomarkers and their potential and actual applications in medicine. The journal facilitates translation of our research knowledge into the clinic to increase the effectiveness of medical practice. As the scientific rationale and regulatory acceptance for biomarkers in medicine and in drug development become more fully established, Biomarkers in Medicine provides the platform for all players in this increasingly vital area to communicate and debate all issues relating to the potential utility and applications. Each issue includes a diversity of content to provide rounded coverage for the research professional. Articles include Guest Editorials, Interviews, Reviews, Research Articles, Perspectives, Priority Paper Evaluations, Special Reports, Case Reports, Conference Reports and Company Profiles. Review coverage is divided into themed sections according to area of therapeutic utility with some issues including themed sections on an area of topical interest. Biomarkers in Medicine provides a platform for commentary and debate for all professionals with an interest in the identification of biomarkers, elucidation of their role and formalization and approval of their application in modern medicine. The audience for Biomarkers in Medicine includes academic and industrial researchers, clinicians, pathologists, clinical chemists and regulatory professionals.
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