Research from A.R. Gujjar and co-researchers in the area of meningitis described
2009 JUL 13 - (NewsRx.com) -- "Tuberculous meningitis (TBM) is a fairly common, debilitating disease and is often complicated by arteritis resulting in brain infarction. Few treatment regimes specifically address this condition," scientists writing in the journal Neurocritical Care report. "Hypervolemia-hypertension-hemodilution (HHH) regime is known to be effective for treatment of vasospasm complicating subarachnoid hemorrhage. We studied the efficacy of HHH regime in patients with TBM with arteritis using a prospective, randomized study design. diagnosed to have TB meningitis by clinical, CSF, and imaging findings were evaluated for arteritis, which was recognized by presence of focal neurologic deficits with or without corresponding focal hypodensities on brain CT scan. with deficits of < 96 h were randomized to HHH or conservative treatment. All patents received four-first-line anti-TB drugs and Inj.dexamethasone. HHH therapy was administered over 3-9 days. Neurologic status and modified Rankin score were noted serially and at discharge. Seven patients received HHH and 5, conservative treatment. All had hemiparesis with power 0-3/5. Median GCS was worse in HHH group (11 vs. 13). In the HHH group, 6/7 improved in motor power, and 5/7 in sensorium. In the control group, 3/5 improved in motor power and 3/5 in sensorium. Four patients died in each group. HHH therapy is safe and may be beneficial in the management of patients with infective arteritis secondary to TBM," wrote A.R. Gujjar and colleagues. The researchers concluded: "Further study in a larger group with improved monitoring of cerebral circulation is indicated.." Gujjar and colleagues published their study in Neurocritical Care (HHH Regime for Arteritis Secondary to TB Meningitis: A Prospective Randomized Study. Neurocritical Care, 2009;10(3):313-317). Additional information can be obtained by contacting A.R. Gujjar, National Institute Mental Health & Neuroscience, Dept. of Neurology, Bangalore 560029, Karnataka, India. The publisher of the journal Neurocritical Care can be contacted at: Humana Press Inc., 999 Riverview Drive Suite 208, Totowa, NJ 07512, USA. Keywords: India, Bangalore, Angiology, Arteritis, Brain Infarction, Cardiology, Central Nervous System Disease, Critical Care, Hemodilution, Hypertension, Infectious Disease, Meningitis, Subarachnoid Hemorrhage, Therapy, Treatment, Tuberculosis. This article was prepared by Tuberculosis Week editors from staff and other reports. Copyright 2009, Tuberculosis Week via NewsRx.com.
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