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Surgical Therapy

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Tuberculosis of the Central Nervous System

Abstract

Antituberculous (anti-TB) therapy is the cornerstone of appropriate treatment for central nervous system TB. However, in many patients diagnosis remains under question, or medical regimens are not successful, and severe complications needing surgical intervention may occur. Outcome and quality of life in neuro-TB patients remain a constant challenge, in spite of the modern surgical strategies and techniques. In addition, there are no absolute guidelines for the treatment of cranial and brain TB due to the variable clinical presentations, sites, severities, and the lack of information from randomized controlled trials. For these reasons, it is needed to develop a final surgical treatment plan for each patient within a multidisciplinary team approach for the successful management. The three most important forms of craniocerebral TB that require surgery are brain tuberculomas, hydrocephalus, and extensive cranial osteomyelitis. The aim of this chapter is to expose the different surgical procedures used in the treatment of cranial and intracranial TB including cranial osteomyelitis, intracranial tuberculoma, brain abscess, and some cerebrovascular brain lesions. Also, the current controversies in the surgical management of main manifestations of this complex infectious illness are discussed.

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Abbreviations

AFB:

Acid-fast bacilli

Anti-TB:

Antituberculous

CNS:

Central nervous system

CSF:

Cerebrospinal fluid

CT:

Computed tomography

HIV:

Human immunodeficiency virus

IICP:

Increased intracranial pressure

MRI:

Magnetic resonance imaging

Neuro-TB:

Neurotuberculosis

SAH:

Subarachnoid hemorrhage

TB:

Tuberculosis

TBA:

Tuberculous brain abscess

TBM:

Tuberculous meningitis

References

  1. DeLance AR, Safaee M, Oh MC, Clark AJ, Kaur G, Sun MZ, Bollen AW, Phillips JJ, Parsa AT (2013) Tuberculoma of the central nervous system. J Clin Neurosci 20:1333–1341

    Article  PubMed  Google Scholar 

  2. Li H, Liu W, You C (2012) Central nervous system tuberculoma. J Clin Neurosci 19:691–695

    Article  PubMed  Google Scholar 

  3. Rajshekhar V (2015) Surgery for brain tuberculosis: a review. Acta Neurochir 157:1665–1678

    Article  PubMed  Google Scholar 

  4. Akhaddar A, Boucetta M (2011) Images in clinical medicine. Multiple intracranial tuberculomas. N Engl J Med 365:1527

    Article  CAS  PubMed  Google Scholar 

  5. Adachi K, Yoshida K, Tomita H, Niimi M, Kawase T (2004) Tuberculoma mimicking falx meningioma-case report. Neurol Med Chir (Tokyo) 44:489–492

    Article  Google Scholar 

  6. Aggarwal A, Patra DP, Gupta K, Sodhi HB (2016) Dural tuberculoma mimicking meningioma: a clinicoradiologic review of dural en-plaque lesions. World Neurosurg 88:e1–e7

    Article  Google Scholar 

  7. Raheja A, Kedia S, Sinha S, Nambirajan A, Sharma MC (2014) Giant extra-axial en-plaque tuberculoma with gyriform enhancement: unusual presentation of a common disease. Neurol India 62:697–699

    Article  PubMed  Google Scholar 

  8. Akhaddar A, Mahi M, Harket A, Elmostarchid B, Belhachemi A, Elasri A, Gazzaz M, Boucetta M (2007) Brainstem tuberculoma in a postpartum patient. J Neuroradiol 34:345–346

    Article  CAS  PubMed  Google Scholar 

  9. Ersahin M, Hakan T, Ayan E, Berkman Z, Ekinci O, Ceran N, Aker FV (2010) Diagnostic and therapeutic role of CT-guided stereotactic surgery in the management of intracranial tuberculomas. Turk Neurosurg 20:295–302

    PubMed  Google Scholar 

  10. Ranjan A, Chandy MJ (1994) Intrasellar tuberculoma. Br J Neurosurg 8:179–185

    Article  CAS  PubMed  Google Scholar 

  11. Aversa do Souto A, Fonseca AL, Gadelha M, Donangelo I, Chimelli L, Domingues FS (2003) Optic pathways tuberculoma mimicking glioma: case report. Surg Neurol 60:349–353

    Article  PubMed  Google Scholar 

  12. Chatterjee S, Saini J, Kesavadas C, Arvinda HR, Jolappara M, Gupta AK (2010) Differentiation of tubercular infection and metastasis presenting as ring enhancing lesion by diffusion and perfusion magnetic resonance imaging. J Neuroradiol 37:167–171

    Article  CAS  PubMed  Google Scholar 

  13. Doraiswamy V, Vaswani RK, Lahiri KR, Kondekar SS (2010) Neurotoxoplasmosis mimicking intracranial tuberculoma. J Postgrad Med 56:31–34

    Article  CAS  PubMed  Google Scholar 

  14. Peng J, Ouyang Y, Fang WD, Luo TY, Li YM, Lv FJ, Zhang ZW, Li XY (2012) Differentiation of intracranial tuberculomas and high grade gliomas using proton MR spectroscopy and diffusion MR imaging. Eur J Radiol 81:4057–4063

    Article  PubMed  Google Scholar 

  15. Raheja A, Sinha S, Sable MN, Sharma MC, Sharma BS (2015) A case of giant intracranial tuberculoma in an infant: clinical and radiologic pitfalls. J Child Neurol 30:364–367

    Article  PubMed  Google Scholar 

  16. Shih RY, Koeller KK (2015) Bacterial, fungal, and parasitic infections of the central nervous system: radiologic-pathologic correlation and historical perspectives. Radiographics 35:1141–1169

    Article  PubMed  Google Scholar 

  17. Sumer S, Koktekir E, Demir NA, Akdemir G (2015) Intracranial giant tuberculoma mimicking brain tumor: a case report. Turk Neurosurg 25:337–339

    PubMed  Google Scholar 

  18. Yamashita K, Suzuki Y, Yoshizumi H, Takahashi JB, Nogawa T (1994) Tuberculous hypertrophic pachymeningitis involving the posterior fossa and high cervical region-case report. Neurol Med Chir (Tokyo) 34:100–103

    Article  CAS  Google Scholar 

  19. Akhaddar A, El Hassani MY, Chakir N, Jiddane M (2011) Optochiasmatic tuberculoma: complication of tuberculous meningitis. Report of a case and review of the literature (in French). J Neuroradiol 28:137–142

    Google Scholar 

  20. Teoh R, Poon W, Humphries MJ, O’Mahony G (1988) Suprasellar tuberculoma developing during treatment of tuberculous meningitis requiring urgent surgical decompression. J Neurol 235:321–322

    Article  CAS  PubMed  Google Scholar 

  21. Barlas O, Sencer A, Erkan K, Eraksoy H, Sencer S, Bayindir C (1999) Stereotactic surgery in the management of brain abscess. Surg Neurol 52:404–410

    Article  CAS  PubMed  Google Scholar 

  22. Mohanty A, Venkatarama SK, Vasudev MK, Khanna N, Anandh B (1999) Role of stereotactic aspiration in the management of tuberculous brain abscess. Surg Neurol 51:443–446

    Article  CAS  PubMed  Google Scholar 

  23. Akhaddar A, Bourazza A, El Mostarchid B, Rouimi A, Boutaleb N, Ouahabi H, Mosseddaq R (2000) Brainstem tuberculomas: two cases (in French). Rev Neurol (Paris) 156:399–402

    CAS  Google Scholar 

  24. Nadvi SS, Van Dellen JR, Gouws E (1995) Transcranial Doppler ultrasonography in hydrocephalic children with tuberculous meningitis. Br J Neurosurg 9:519–526

    Article  CAS  PubMed  Google Scholar 

  25. Raut T, Garg RK, Jain A, Verma R, Singh MK, Malhotra HS, Kohli N, Parihar A (2013) Hydrocephalus in tuberculous meningitis: Incidence, its predictive factors and impact on the prognosis. J Infect 66:330–337

    Article  PubMed  Google Scholar 

  26. Akhaddar A (2015) Infective complications. In: Di Rocco C, Turgut M, Jallo G, Martinez-Lage DJF (eds) Complications of CSF shunting in Hydrocephalus. Springer International Publishing, Cham, pp 141–148

    Google Scholar 

  27. Mohindra S (2012) Symptomatic, paradoxical intracranial tuberculomas along non-functional ventricular catheter necessitating its removal. Br J Neurosurg 26:909–911

    Article  PubMed  Google Scholar 

  28. AlSemari A, Baz S, Alrabiah F, Al-Khairallah T, Qadi N, Kareem A, Alrajhi AA (2012) Natural course of epilepsy concomitant with CNS tuberculomas. Epilepsy Res 99:107–111

    Article  PubMed  Google Scholar 

  29. Cheng VC, Ho PL, Lee RA, Chan KS, Chan KK, Woo PC, Lau SK, Yuen KY (2002) Clinical spectrum of paradoxical deterioration during antituberculosis therapy in non-HIV-infected patients. Eur J Clin Microbiol Infect Dis 21:803–809

    Article  CAS  PubMed  Google Scholar 

  30. Menon S, Bharadwaj R, Chowdhary A, Kaundinya D, Palande D (2011) Tuberculous brain abscesses: case series and review of literature. J Neurosci Rural Pract 2:153–157

    Article  PubMed  PubMed Central  Google Scholar 

  31. Naama O, Boulahroud O, Elouennass M, Akhaddar A, Gazzaz M, Elmoustarchid B, Boucetta M (2010) Primary tuberculous cerebellar abscess in an immunocompetent adult. Intern Med 49:875–876

    Article  PubMed  Google Scholar 

  32. Whitener DR (1978) Tuberculous brain abscess. Report of a case and review of the literature. Arch Neurol 35:148–155

    Article  CAS  PubMed  Google Scholar 

  33. Chakraborti S, Mahadevan A, Govindan A, Nagarathna S, Santosh V, Yasha TC, Devi BI, Chandramouli BA, Kovoor JM, Chandramuki A, Shankar SK (2009) Clinicopathological study of tuberculous brain abscess. Pathol Res Pract 205:815–822

    Article  PubMed  Google Scholar 

  34. Cárdenas G, Soto-Hernández JL, Orozco RV, Silva EG, Revuelta R, Amador JL (2010) Tuberculous brain abscesses in immunocompetent patients: management and outcome. Neurosurgery 67:1081–1087

    Article  PubMed  Google Scholar 

  35. Narang M, Gomber S, Upreti L, Dua S (2010) Multiple intracranial tubercular abscesses in a child. Kathmandu Univ Med J (KUMJ) 8:244–246

    CAS  Google Scholar 

  36. Joshi V, Germano I, Meenakshi R, Doshi A (2014) Paradoxical evolution of a cerebellar tuberculosis abscess after surgical drainage and antibiotic therapy. Surg Neurol Int 5:143

    Article  PubMed  PubMed Central  Google Scholar 

  37. Mohindra S, Savardekar A, Gupta R, Tripathi M, Rane S (2016) Tuberculous brain abscesses in immunocompetent patients: a decade long experience with nine patients. Neurol India 64:66–74

    Article  PubMed  Google Scholar 

  38. Pandit V, Valsalan R, Seshadri S, Bahuleyan S (2009) Disseminated tuberculosis presenting as mesenteric and cerebral abscess in HIV infection: case report. Braz J Infect Dis 13:383–386

    Article  PubMed  Google Scholar 

  39. du Plessis J, Andronikou S, Wieselthaler N, Theron S, George R, Mapukata A (2007) CT features of tuberculous intracranial abscesses in children. Pediatr Radiol 37:167–172

    Article  PubMed  Google Scholar 

  40. Gupta RK, Vatsal DK, Husain N, Chawla S, Prasad KN, Roy R, Kumar R, Jha D, Husain M (2001) Differentiation of tuberculous from pyogenic brain abscesses with in vivo proton MR spectroscopy and magnetization transfer MR imaging. AJNR Am J Neuroradiol 22:1503–1509

    CAS  PubMed  Google Scholar 

  41. Gump WC, Summers LE, Walsh JW (2006) Tuberculosis infection presenting as brain abscess in an immunocompromised host. J La State Med Soc 158:292–295

    PubMed  Google Scholar 

  42. Megarbane B, Lebrun L, Marchal P, Axler O, Brivet FG (2000) Fatal Mycobacterium tuberculosis brain abscess in an immunocompetent patient. Scand J Infect Dis 32:702–703

    Article  CAS  PubMed  Google Scholar 

  43. Vidal JE, Penalva de Oliveira AC, Bonasser Filho F, Schiavon Nogueira R, Dauar RF, Lins DL, Coelho JF (2005) Tuberculous brain abscess in AIDS patients: report of three cases and literature review. Int J Infect Dis 9:201–207

    Article  CAS  PubMed  Google Scholar 

  44. Akhaddar A, Elouennass M, Baallal H, Boucetta M (2010) Focal intracranial infections due to Actinomyces species in immunocompetent patients: diagnostic and therapeutic challenges. World Neurosurg 74:346–350

    Article  PubMed  Google Scholar 

  45. Kim PD, Hall WA (2014) Bacterial brain abscess. In: Hall WA, Kim PD (eds) Neurosurgical infectious disease: surgical and nonsurgical management. Thieme, New York, pp 95–103

    Google Scholar 

  46. Akhaddar A, El Mostarchid B, Gazzaz M, Boucetta M (2002) Cerebellar abscess due to Lactococcus lactis. A new pathogen. Acta Neurochir (Wien) 144:305–306

    Article  CAS  Google Scholar 

  47. Simsek H, Kutlay M, Colak A, Haholu A, Kaya H, Ozyurt M, Demircan MN (2013) Concomitant tubercular and fungal cerebellar abscess in an immunocompromised girl. Turk Neurosurg 23:88–94

    PubMed  Google Scholar 

  48. Muzumdar D, Jhawar S, Goel A (2011) Brain abscess: an overview. Int J Surg 9:136–144

    Article  PubMed  Google Scholar 

  49. Barber PA, Sieradzan KS, Schady W (1999) Superior sagittal sinus obstruction and tuberculous abscess. Acta Neurol Scand 99:202–203

    Article  CAS  PubMed  Google Scholar 

  50. Akhaddar A, Baallal H, Elouennass M, Elgharbaoui H, Mahi M, Boucetta M (2011) Combined Serratia liquefaciens and Mycobacterium tuberculosis in temporal osteitis with brain extension. Surg Infect (Larchmt) 12:329–331

    Article  Google Scholar 

  51. Siddiqui AA, Sarwari AR, Chishti KN (2001) Concomitant tuberculous and pyogenic brain abscess. Int J Tuberc Lung Dis 5:100–101

    CAS  PubMed  Google Scholar 

  52. Banerjee AD, Pandey P, Ambekar S, Chandramouli BA (2010) Pediatric intracranial subdural empyema caused by Mycobacterium tuberculosis – a case report and review of literature. Childs Nerv Syst 26:1117–1120

    Article  PubMed  Google Scholar 

  53. Nathoo N, Nadvi SS, Gouws E, van Dellen JR (2001) Craniotomy improves outcomes for cranial subdural empyemas: computed tomography-era experience with 699 patients. Neurosurgery 49:872–877

    CAS  PubMed  Google Scholar 

  54. Turel MK, Moorthy RK, Rajshekhar V (2012) Multidrug-resistant tuberculous subdural empyema with secondary methicillin-resistant Staphylococcus aureus infection: an unusual presentation of cranial tuberculosis in an infant. Neurol India 60:231–234

    Article  PubMed  Google Scholar 

  55. Gettler JF, El-Sadr W (1993) Cranial epidural abscess due to Mycobacterium tuberculosis in a patient infected with the human immunodeficiency virus. Clin Infect Dis 17:289–290

    Article  CAS  PubMed  Google Scholar 

  56. Jacques C, Boukobza M, Polivka M, Ferrario A, George B, Merland JJ (2000) Cranial epidural tuberculoma. A case report. Acta Radiol 41:367–370

    Article  CAS  PubMed  Google Scholar 

  57. Tripathi AK, Gupta N, Khanna M, Ahmad R, Tripathi P (2007) Tuberculosis presenting as osteolytic soft tissue swellings of skull in HIV positive patient: a case report. Indian J Tuberc 54:193–195

    CAS  PubMed  Google Scholar 

  58. Akhaddar A (2016) Unusual pathogens. In: Akhaddar A (ed) Cranial osteomyelitis. Diagnosis and treatment. Springer International Publishing, Cham, pp 259–283

    Chapter  Google Scholar 

  59. Gupta PK, Kolluri VR, Chandramouli BA, Venkataramana NK, Das BS (1989) Calvarial tuberculosis: a report of two cases. Neurosurgery 25:830–833

    Article  CAS  PubMed  Google Scholar 

  60. Mukherjee KK, Kaushik R, Nada R, Khosla VK, Khandelwal N, Kak VK (2002) Calvarial tuberculosis. Surg Neurol 57:195–202

    Article  CAS  PubMed  Google Scholar 

  61. Tyagi AK, Kirollos RW, Kang NV (1996) Tuberculous osteitis of the skull: a case report and review of the literature. Br J Neurosurg 10:399–401

    Article  CAS  PubMed  Google Scholar 

  62. Mohanty S, Rao CJ, Mukherjee KC (1981) Tuberculosis of the skull. Int Surg 66:81–83

    CAS  PubMed  Google Scholar 

  63. Ramdurg SR, Gupta DK, Suri A, Sharma BS, Mahapatra AK (2010) Calvarial tuberculosis: uncommon manifestation of common disease – a series of 21 cases. Br J Neurosurg 24:572–577

    Article  PubMed  Google Scholar 

  64. Akhaddar A (2016) General considerations and surgical therapy. In: Akhaddar A (ed) Cranial osteomyelitis. Diagnosis and treatment. Springer International Publishing, Cham, pp 191–223

    Chapter  Google Scholar 

  65. Sethi A, Sethi D, Mrig S, Passey JC, Srivastav N (2006) Coexistent acute pyogenic and tubercular petrous apicitis: a diagnostic dilemma. J Laryngol Otol 120:875–878

    Article  CAS  PubMed  Google Scholar 

  66. Jadhav RN, Palande DA (1999) Calvarial tuberculosis. Neurosurgery 45:1345–1349

    Article  CAS  PubMed  Google Scholar 

  67. Biniwale SN, Rajshekhar V (2000) Tuberculous osteomyelitis of bone flap following craniotomy for a glioma. Neurol India 48:91–92

    CAS  PubMed  Google Scholar 

  68. Pandey AS, Surana A (2011) Tuberculous osteomyelitis of the bone flap following craniotomy. Indian J Tuberc 58:129–131

    PubMed  Google Scholar 

  69. Sundar VI, Shekhawat J, Gupta A, Sinha VD (2013) Post traumatic tubercular osteomyelitis of skull vault. J Neurosci Rural Pract 4(Suppl 1):138–141

    Article  Google Scholar 

  70. Sundaram PK, Sayed F (2007) Superior sagittal sinus thrombosis caused by calvarial tuberculosis: case report. Neurosurgery 60:E776

    Article  PubMed  Google Scholar 

  71. Zettel H (1961) Post-traumatic tuberculosis of the skull (in German). Monatsschr Unfallheilkd Versicherungsmed 64:299–307

    CAS  PubMed  Google Scholar 

  72. Indira Devi B, Tyagi AK, Bhat DI, Santosh V (2003) Tuberculous osteitis of clivus. Neurol India 51:69–70

    CAS  PubMed  Google Scholar 

  73. Clark MP, Pretorius PM, Byren I, Milford CA (2009) Central or atypical skull base osteomyelitis: diagnosis and treatment. Skull Base 19:247–254

    Article  PubMed  PubMed Central  Google Scholar 

  74. Farshchi S, Hasibi M, Ashtiani MT, Yazdani N, Mokhtari Z, Farshchi A (2013) A misdiagnosis led to an extensive skull base surgery: infratemporal tuberculosis mimicking giant cell tumor. Indian J Otolaryngol Head Neck Surg 65:83–85

    Article  PubMed  Google Scholar 

  75. Chen CH, Chang YJ, Sy HN, Chen WL, Yen HC (2014) Risk assessment of the outcome for cerebral infarction in tuberculous meningitis. Rev Neurol (Paris) 170:512–519

    Article  Google Scholar 

  76. Figaji AA, Sandler SI, Fieggen AG, Le Roux PD, Peter JC, Argent AC (2008) Continuous monitoring and intervention for cerebral ischemia in tuberculous meningitis. Pediatr Crit Care Med 9:e25–e30

    Article  PubMed  Google Scholar 

  77. Gupta K, Radotra BD, Suri D, Sharma K, Saxena AK, Singhi P (2012) Mycotic aneurysm and subarachnoid hemorrhage following tubercular meningitis in an infant with congenital tuberculosis and cytomegalovirus disease. J Child Neurol 27:1320–1325

    Article  PubMed  Google Scholar 

  78. Leiguarda R, Berthier M, Starkstein S, Nogués M, Lylyk P (1988) Ischemic infarction in 25 children with tuberculous meningitis. Stroke 19:200–204

    Article  CAS  PubMed  Google Scholar 

  79. Rotta NT, Silva AR, Firpo-Freire C, Sebben G, Rd S-R, Ohlweiler L (2004) Cerebrovascular disease as an initial finding in childhood tuberculosis meningoencephalitis (in Spanish). Rev Neurol 39:1034–1037

    CAS  PubMed  Google Scholar 

  80. Sahin S, Cansu A, Kamaşak T, Eyüboğlu İ, Esenülkü G, Ökten A (2014) Lumbar puncture requirement in acute hemiparesis: diagnosis of tuberculous meningitis after hemiparesis in a child. Childs Nerv Syst 30:2139–2142

    Article  PubMed  Google Scholar 

  81. Schoeman JF, Van Zyl LE, Laubscher JA, Donald PR (1995) Serial CT scanning in childhood tuberculous meningitis: prognostic features in 198 cases. J Child Neurol 10:320–329

    Article  CAS  PubMed  Google Scholar 

  82. Sheu JJ, Hsu CY, Yuan RY, Yang CC (2012) Clinical characteristics and treatment delay of cerebral infarction in tuberculous meningitis. Intern Med J 42:294–300

    Article  PubMed  Google Scholar 

  83. Wen LS, Noble JA (2011) A case of a young girl with fever and seizure. Acad Emerg Med 18:e86–e92

    Article  PubMed  Google Scholar 

  84. Clemente Morgado T, Kinsky M, Carrara H, Rothemeyer S, Semple P (2013) Prognostic value of computed tomography-evident cerebral infarcts in adult patients with tuberculous meningitis and hydrocephalus treated with an external ventricular drain. World Neurosurg 80:e255–e260

    Article  PubMed  Google Scholar 

  85. Hendin AS, Margolis MT, Glickman MG (1973) Occlusion of the basilar artery in tuberculous meningitis. Neuroradiology 6:193–195

    Article  CAS  PubMed  Google Scholar 

  86. Kashiwagi S, Abiko S, Harada K, Yamashita K, Ito H (1990) Ischemic cerebrovascular complication in tuberculous meningitis; a case of Fröhlich syndrome and hemiparesis (in Japanese). No Shinkei Geka 18:1141–1145

    CAS  PubMed  Google Scholar 

  87. Lammie GA, Hewlett RH, Schoeman JF, Donald PR (2009) Tuberculous cerebrovascular disease: a review. J Infect 59:156–166

    Article  PubMed  Google Scholar 

  88. Lu CH, Chang WN, Chang HW, Chung KJ, Tsai NW, Lui CC, Wang HC (2007) Clinical relevance of intracranial arterial stenoses in tuberculous and cryptococcal meningitis. Infection 35:359–363

    Article  PubMed  Google Scholar 

  89. Pathare AV, Patil RR, Chikhalikar AA, Dalvi SG (1988) Association of tuberculoma with arterio-venous malformation (a case report). J Postgrad Med 34:190–192

    CAS  PubMed  Google Scholar 

  90. Radmanesh F, Nejat F, El Khashab M (2010) Cerebral infarction as the first presentation of tuberculosis in an infant: a case report. J Microbiol Immunol Infect 43:249–252

    Article  PubMed  Google Scholar 

  91. Ramdasi R, Mahore A, Kawale J, Thorve S (2015) Cerebral venous thrombosis associated with tuberculous meningitis: a rare complication of a common disease. Acta Neurochir 157:1679–1680

    Article  PubMed  Google Scholar 

  92. Roh JK, Kang DW (1998) A case of tuberculosis meningitis complicated by intracerebral hemorrhage. Eur Neurol 40:50–52

    Article  CAS  PubMed  Google Scholar 

  93. Uesugi T, Takizawa S, Morita Y, Takahashi H, Takagi S (2006) Hemorrhagic infarction in tuberculous meningitis. Intern Med 45:1193–1194

    Article  PubMed  Google Scholar 

  94. Podlecka A, Dziewulska D, Rafałowska J (1998) Vascular changes in tuberculous meningoencephalitis. Folia Neuropathol 36:235–237

    CAS  PubMed  Google Scholar 

  95. de Almedia GM, Lee KC, Ciappetta P (1997) Middle cerebral artery aneurysm complicated by tuberculosis. Surg Neurol 48:448–450

    Article  PubMed  Google Scholar 

  96. Griffiths SJ, Sgouros S, James G, John P (2000) Intraventricular haemorrhage due to ruptured posterior inferior cerebellar artery aneurysm in tuberculous meningitis. Childs Nerv Syst 16:872–874

    Article  CAS  PubMed  Google Scholar 

  97. Kim IY, Jung S, Jung TY, Kang SS, Moon KS, Joo SP (2008) Intracranial tuberculoma with adjacent inflammatory aneurysms. J Clin Neurosci 15:1174–1176

    Article  PubMed  Google Scholar 

  98. Madhusudan HV, Krishnamoorthy N, Suresh PK, Subramaniam V (2015) Superficial temporal artery pseudoaneurysm presenting as extradural hematoma: a case report and review of literature. Asian J Neurosurg 10:63–65

    Article  PubMed  PubMed Central  Google Scholar 

  99. Saraf R, Limaye U (2013) Ruptured intracranial tubercular infectious aneurysm secondary to a tuberculoma and its endovascular management. Br J Neurosurg 27:243–245

    Article  CAS  PubMed  Google Scholar 

  100. Vitali AM (2008) Acquired encephalocele attributable to tuberculous osteitis: case report. Neurosurgery 62:E976

    Article  PubMed  Google Scholar 

  101. Chatterjee D, Radotra BD, Vasishta RK, Sharma K (2015) Vascular complications of tuberculous meningitis: an autopsy study. Neurol India 63:926–932

    Article  PubMed  Google Scholar 

  102. Shuangshoti S, Phisitbutr M (1979) Fatal hemorrhage in tuberculosis of the brain. J Med Assoc Thai 62:639–645

    CAS  PubMed  Google Scholar 

  103. Choi H, Hall WA, Deshaies EM (2014) Infectious intracranial aneurysms. In: Hall WA, Kim PD (eds) Neurosurgical infectious disease: surgical and nonsurgical management. Thieme, New York, pp 133–146

    Google Scholar 

  104. Manka R, Lentini S, Manka C, Lüderitz B, Tasci S (2005) A case of arteria cerebri aneurysm, sepsis, and miliary lung infiltrates in a 32-year-old woman (in German). Med Klin (Munich) 100:740–743

    Article  Google Scholar 

  105. Chun JY, Smith W, Halbach VV, Higashida RT, Wilson CB, Lawton MT (2001) Current multimodality management of infectious intracranial aneurysms. Neurosurgery 48:1203–1213

    CAS  PubMed  Google Scholar 

  106. Misch M, Thomale UW, Keitzer R, Vajkoczy P (2010) Prevention of secondary ischemic events by superficial temporal artery-middle cerebral artery bypass surgery after tuberculosis-induced vasculopathy in a 5-year-old child. J Neurosurg Pediatr 6:69–72

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Avicenne Military Hospital of Marrakech, Mohammed V University in Rabat, Rabat, Morocco

    Ali Akhaddar MD, IFAANS

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  1. Ali Akhaddar MD, IFAANS
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Correspondence to Ali Akhaddar MD, IFAANS .

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Editors and Affiliations

  1. Adnan Menderes University, School of Medicine, Aydın, Turkey

    Mehmet Turgut

  2. Mohammed V University in Rabat, Avicenne Military Hospital of Marrakech, Rabat, Morocco

    Ali Akhaddar

  3. Hacettepe University, School of Medicine, Ankara, Turkey

    Ahmet T. Turgut

  4. King George Medical University, Lucknow, Uttar Pradesh, India

    Ravindra K. Garg

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Akhaddar, A. (2017). Surgical Therapy. In: Turgut, M., Akhaddar, A., Turgut, A., Garg, R. (eds) Tuberculosis of the Central Nervous System. Springer, Cham. https://doi.org/10.1007/978-3-319-50712-5_14

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