CHRONIC TUBERCULOUS MENINGOENCEPHALOPATHY PRESENTING AS NEURODEGENERATIVE DISORDER. - A CASE REPORT.
Srikanth Reddy A (PG student)*, Kalyanshettar S S (Asst.Prof)**, Patil S V (Prof)***, Akki A S (Prof & HOD)****
Dept. of Pediatrics, B.M.Patil Medical College, Bijapur. *, Dept. of Pediatrics, B.M.Patil Medical College, Bijapur. **, Dept. of Pediatrics, B.M.Patil Medical College, Bijapur. ***, Dept. of Pediatrics, B.M.Patil Medical College, Bijapur. ****
Abstract
We are reporting a case of 12-year-old male child presenting with convulsions, and aphasia of 8 days duration. History revealed progressive hearing loss since 1 year, gait abnormality & left sided hemiparesis since 6 months. Fundoscopy revealed bilateral papilledema. Cranial CT scan showed Subarachnoid hemorrhage in right sylvian cistern extending into lateral ventricles. CSF Investigations showed xanthochromic cerebrospinal fluid with elevated proteins more than 500mg/dl; sugar levels 25mg/dl and chloride levels 110mEq/L. Cell type was predominantly lymphocytic with negative ZN staining for Acid-fast bacilli. CSF-Adenosine deaminase levels were elevated (49U/L). Patient was started on 4 ATT drugs with steroids and responded well. SAH in Tuberculous meningitis may occur as result of Vasculitis causing hemorrhage. Fibrinoid degeneration of small arteries and veins can produce aneurysms, multiple thrombi or focal hemorrhages that might be the cause in this case.

Keywords: Tuberculous meningitis, Sub-Arachnoid Hemorrhage, Adenosine Deaminase
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