Cerebral angiographic features in tuberculous meningitis

Abstract

Cerebral angiographic findings of 10 cases of tuberculous meningitis are presented. Narrowing and occlusion of intracranial arteries were the major findings, the most common sites of abnormalities being the supraclinoid portion of the carotid artery and proximal portion of the anterior and middle cerebral arteries. The branches of the intracranial arteries were also involved. The extracranial portion of the internal carotid was found to be uniformly narrow in few cases. Three types of collaterals were seen-the net-like cluster of thin vessels in the region of basal ganglia and base of the brain, transdural external-internal carotid anastomosis, and increased cortical anastomosis with altered architecture of the arrangement. "Early veins" were also seen. Hydrocephalic pattern and delayed circulation were the other features. The resemblance of the net-like cluster of the vessels at the region of the basal ganglia to those described in moyamoya disease is pointed out. It is suggested that these peculiar collaterals are confined to intracranial arterial occlusions related to some inflammatory process in young people.