Chiari malformation and tuberculous meningitis: aetiology and management

This is the first reported case of a Chiari 1 malformation in association with tuberculous (TB) meningitis. We present a case of a 23-year-old woman with a 2-week history nocturnal fever, vertigo, headache and projectile vomiting. She had nystagmus, scanning speech, bilateral papilloedema and ataxia...

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Bibliographic Details
Published in:	BMJ case reports Vol. 2018; p. bcr-2018-224245
Main Authors:	Diestro, Jose Danilo Bengzon, Bautista, Jesi Ellen Cueto, Omar II, Abdelsimar T, Mercado, James Garcia, Ramiro, Philip Asuncion
Format:	Journal Article
Language:	English
Published:	England BMJ Publishing Group 05-04-2018
Series:	Case Report
Subjects:	Arnold-Chiari Malformation - diagnosis Arnold-Chiari Malformation - physiopathology Arnold-Chiari Malformation - rehabilitation Arnold-Chiari Malformation - therapy Cranial Fossa, Posterior - diagnostic imaging Cranial Fossa, Posterior - surgery Decompression, Surgical - methods Disease Progression Female Fever - etiology Headache - etiology Humans Magnetic Resonance Imaging Spinal Puncture Treatment Outcome Tuberculosis, Meningeal - diagnosis Tuberculosis, Meningeal - physiopathology Tuberculosis, Meningeal - rehabilitation Tuberculosis, Meningeal - therapy Unusual Association of Diseases/Symptoms Vertigo - etiology Vomiting - etiology Young Adult tb and other respiratory infections brain stem / cerebellum hydrocephalus neurosurgery meningitis
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Summary:	This is the first reported case of a Chiari 1 malformation in association with tuberculous (TB) meningitis. We present a case of a 23-year-old woman with a 2-week history nocturnal fever, vertigo, headache and projectile vomiting. She had nystagmus, scanning speech, bilateral papilloedema and ataxia. Cranial imaging showed a 10 mm tonsillar herniation. Posterior fossa decompression was done. Because the patient’s gamut of symptoms was highly suspicious for a central nervous system infection, a lumbar tap was done which revealed TB meningitis. Four years later, after anti-TB medications and rehabilitation, all her symptoms except gait instability resolved.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1757-790X 1757-790X
DOI:	10.1136/bcr-2018-224245