A17.1

Clinical Causes: Infection with Mycobacterium tuberculosis, the bacteria responsible for tuberculosis Spread of TB bacteria from a primary site, such as the lungs, to the central nervous system Hematogenous dissemination, where bacteria enter the bloodstream and reach the meninges Reactivation of a latent TB infection within the central nervous system

Key Symptoms: Persistent headaches Neurological deficits, such as weakness or numbness Seizures Altered mental status or confusion Fever and night sweats Weight loss Signs of increased intracranial pressure, like nausea and vomiting Visual disturbances

Diagnosis Path: Diagnosis typically involves a combination of neurological examination, imaging studies, and laboratory tests. Magnetic resonance imaging (MRI) and computed tomography (CT) scans can reveal the presence of a mass in the meninges. A definitive diagnosis may require a biopsy or cerebrospinal fluid analysis to identify Mycobacterium tuberculosis. Additional tests, such as tuberculosis skin tests or blood tests, can support the diagnosis and determine infection exposure.

Treatment Protocols: Treatment usually involves a prolonged course of anti-tuberculosis medications, often lasting several months. The standard therapy includes drugs such as isoniazid, rifampicin, ethambutol, and pyrazinamide. In some cases, corticosteroids are prescribed to reduce inflammation and intracranial pressure. Surgical intervention may be necessary to remove the mass if it causes significant neurological impairment or does not respond to medical therapy. Regular follow-up with healthcare providers ensures management of treatment response and monitoring for potential complications.