ArticlePloS one2016
Role of Transcranial Doppler in the Evaluation of Vasculopathy in Tuberculous Meningitis.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 20 citations in OpenAlex.
- Paradoxical manifestations during tuberculous meningitis treatment among HIV-negative patients: a retrospective descriptive study and literature review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022Review
- Treatment Outcomes in Adult Tuberculous Meningitis: A Systematic Review and Meta-analysis.Open forum infectious diseases · 2020Article
- Transcranial Doppler for Monitoring and Evaluation of Idiopathic Intracranial Hypertension.Journal of neurosciences in rural practice · 2020Article
- Research progress in ultrasound use for the diagnosis and treatment of cerebrovascular diseases.Clinics (Sao Paulo, Brazil) · 2019Review
- Knowledge gaps and research priorities in tuberculous meningitis.Wellcome open research · 2019Article
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVascular complications are important causes of cerebral infarction in tuberculous meningitis (TBM).Transcranial Doppler ultrasonography (TCD) is a non-invasive tool that can provide real-time information about cerebral hemodynamics. However, the literature on the role of TCD in the diagnosis or monitoring of vasculopathy associated with TBM is scarce. We explored the role of TCD in the diagnosis and monitoring of TBM-related vasculopathy of the major intracranial arteries.
methodsConsecutive patients with TBM admitted to our tertiary center between 2011 and 2015 were included. All patients underwent TCD evaluation within 2 weeks of hospitalisation and it was repeated 2 weeks later. Mean flow velocity (Vmean) and pulsatility index (PI) were recorded. Flow velocities obtained from the submandibular internal carotid artery were also measured to calculate the Lindegaard ratio. A correlation was made between the patients who demonstrated vasculopathy on TCD, and patients with confirmed focal narrowing on computed tomography angiography (CTA) or magnetic resonance angiography (MRA). The modified Rankin scale (mRS) was used to assess the clinical outcome at three and six months.
resultsA total of 36 patients were recruited. Focally elevated flow velocities in the middle cerebral artery (MCA) were observed in 11 (30.6%) patients, bilaterally in 6 of them. The Lindegaard ratio was elevated (>3) in 10 (90.9%) of them, which occurred as early as the fourth day of hospitalization and persisted as long as four months. Eighty percent of patients with TBM vasculopathy by TCD criteria, also had narrowing on CTA or MRA. Ten patients (27.8%) achieved good outcome (mRS 0-2) at 3 months, which increased to 13 (36.1%) at 6 months.
conclusionA considerable proportion of patients with TBM develops intracranial vasculopathy, which can be reliably diagnosed and monitored using TCD.
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