Tuberculosis meningitis is an inflammation of mostly soft membranes of the brain. The disease is secondary, that is, it occurs against a background of a lung or other internal organs that has been transferred earlier or is in an acute stage of tuberculosis.
How is tuberculous meningitis transmitted?
The causative agent of the disease is the tuberculosis microbacterium. In the brain, it usually comes from another, primary source of infection. Only in 3% of cases the exact cause of the disease can not be established, in all other cases the primary focus of tuberculosis infection is observed in the body. The main way of spreading a bacterium is considered to be its transfer through the blood, and infection takes place in two stages:
- At the first stage, a breakthrough of tuberculosis bacteria through the vascular barrier and infection of the vascular plexuses of the brain envelope occurs.
- In the second stage of tuberculous meningitis, bacteria seep into the spinal fluid (cerebrospinal fluid), causing inflammation of the soft shell of the brain.
Symptoms of tuberculous meningitis
There are 3 stages of development of tuberculous meningitis.
The prodromal period
It lasts up to 6-8 weeks with a gradual development of symptoms. The first appear:
- lethargy;
- apathy;
- general weakness;
- drowsiness;
- dizziness;
- periodic headaches.
Over time, the headache increases, nausea, vomiting, body temperature subfebrile, but can rise to 38 degrees.
Irritation period
At this stage, the symptoms increase dramatically, body temperature can rise to 39 ° C. Observed:
- severe pain in the frontal and occipital part of the head;
- constipation without bloating;
- intolerance to noise;
- photophobia.
Spontaneously appear and disappear red spots on the skin (vascular disorders).
On the 5th-7th day of this period meningeal syndromes appear:
- stiff neck;
- a symptom of Körnig and Brudzinsky.
Also can be observed:
- fluctuations in blood pressure;
- increased flow and salivation;
- visual disorders (strabismus, decreased vision, paralysis of the eyelid);
- hearing impairment;
- decreased sensitivity of the limbs;
- speech impairment;
- hydrocephalus.
Terminal period
The last stage of the disease. Symptoms characteristic of encephalitis are observed, as well as:
- paresis and paralysis of a central character;
- tachycardia;
- breathing disorders;
- persistent loss of consciousness;
- body temperature is high (about 40 degrees).
The last stage of the disease, usually ends in a fatal outcome.
Diagnosis and treatment of tuberculous meningitis
If there is a suspicion of tuberculous meningitis, the main diagnostic method is the analysis of cerebrospinal fluid. Pressure in the spinal canal with such a disease is usually increased, because when taking a puncture, the jet of liquor will flow as if under pressure. At laboratory researches in liquor the raised maintenance of fibers and leucocytes, besides antibodies to a stick of Koch are found out. Recently, computer and magnetic resonance imaging have been used to establish brain damage.
Treatment of the disease for a long time (a year or more) and conducted in specialized boarding houses and dispensaries. Includes taking drugs according to special schemes, as with any other form of tuberculosis. For the treatment of symptoms used:
- antioxidants ;
- nootropic drugs;
- antihypoxants;
- diuretics (to reduce the edema of the brain);
- general detoxification therapy.
Consequences of tuberculous meningitis
The most common complication arising in the course of the disease is hydrocephalus (hydrocephalus). In addition, epileptic seizures are possible, muscle paralysis on one side of the body, and visual impairment (in rare cases, before its complete loss). In case of untimely application for medical care (18 or more days of illness), the probability of a fatal outcome is high.