Clinical, Imaging, and Laboratory Characteristics of Adult Mexican Patients with Tuberculous Meningitis: A Retrospective Cohort Study.

Tuberculous Meningitis (TBM) is the most common form of central nervous system Tuberculosis (TB), accounting for 5-6% of extrapulmonary TB cases. Nowadays, TBM continues to be a major topic in public health because of its high prevalence worldwide. This retrospective study aimed to describe the clinical, laboratory, and imaging characteristics at admission; and in-hospital outcome of adult Mexican patients with TBM.

Conduction Aphasia as Initial Manifestation of Tuberculous Meningitis.

Conduction aphasia being the arcuate fasciculus of the site of structural injury is a speech disorder characterized by fluent, spontaneous speech and paraphasias, intact auditory comprehension, and limited repetition. One of the causes of stroke in young adults is the Mycobacterium tuberculosis (MTB) infection, which may cause cerebral ischemia secondary to artery obliteration. In this case report, we present a previously healthy 24-year-old woman that presented with a sudden onset of aphasia; MTB was identified as the etiological agent.

New-Onset Diabetes Presenting as Monoballism Secondary to a Mixed Hyperglycemic Crisis.

Monoballism secondary to a mixed hyperglycemic crisis is a rare initial symptom of new-onset diabetes, which commonly affects the elderly and Asian women having inadequate glycemic control. In hyperglycemic states, the elevated serum glucose levels raise the viscosity of the blood reducing cerebral perfusion, decreasing gamma-aminobutyric acid levels, the latter being an inhibitory neurotransmitter of thalamocortical stimuli. In this case, we report a previously healthy 41-year-old male who attended the emergency department because of an abrupt onset movement disorder of the left arm, this being compatible with monoballism.

Bilateral Thalamic Ischemic Stroke Secondary to Occlusion of the Artery of Percheron.

The occlusion of the artery of Percheron (AOP) is a rare condition that causes bilateral thalamic ischemic stroke with or without midbrain involvement. It happens as a result of an anatomical variant of the diencephalic irrigation, in which the thalamic paramedian arteries arise from a common trunk from the posterior cerebral artery (PCA), which generates a clinical syndrome characterized by bilateral vertical gaze palsy, memory impairment and hypersomnia. In this case, we report a 62-year-old woman admitted to the emergency room with altered mental status, mainly somnolence.

Dural metastases as a presentation of a Brenner tumor.

We present a 56-year-old woman who came to our institution with a 6-month history of intracranial hypertension. Imaging studies showed diffuse dural enhancement, multiple lytic bone lesions and a tumor in the left ovary. A meningeal biopsy was performed; however, during this procedure the patient developed profuse dural hemorrhage and middle cerebral artery territory infarction and died a few hours later.