Andre Marolop Pangihutan Siahaan1, Steven Tandean2, Rr Suzy Indharty2, Bahagia Willibrodus Maria Nainggolan3, Martin Susanto4. 1. Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia. Electronic address: andremarolop@usu.ac.id. 2. Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia. 3. Student Research Assistant, Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia. 4. Petang II Public Health Center, Bali, Indonesia.
Abstract
INTRODUCTION AND IMPORTANCE: Paroxysmal sympathetic hyperactivity syndrome is frequently reported in traumatic brain injury. However, it may occur in non-traumatic brain injury, such as tuberculous meningitis with hydrocephalus. CASE PRESENTATION: We reported a 38-year-old male who presented with acute decrease of consciousness and hemiparesis that was developed during antitubercular drugs therapy. CT Scan showed hydrocephalus and granuloma lesion. Emergency ventriculoperitoneal shunting were performed. During treatment, the patient developed paroxysmal sympathetic syndrome during treatment that was controlled based on symptom elimination and prevention. CLINICAL DISCUSSION: Brain tuberculosis remains a difficult problem for clinicians. Even when antitubercular drugs are administered according to protocol, paradoxical reactions can occur. If hydrocephalus develops, ventriculoperitoneal shunting is one of the options for lowering intracranial pressure. Paroxysmal sympathetic hyperactivity may occur in brain tuberculosis and should be detected as soon as possible to avoid serious morbidity. CONCLUSION: Paroxysmal sympathetic hyperactivity may be developed in brain tuberculosis. Early identification and treatment are mandatory.
INTRODUCTION AND IMPORTANCE: Paroxysmal sympathetic hyperactivity syndrome is frequently reported in traumatic brain injury. However, it may occur in non-traumatic brain injury, such as tuberculous meningitis with hydrocephalus. CASE PRESENTATION: We reported a 38-year-old male who presented with acute decrease of consciousness and hemiparesis that was developed during antitubercular drugs therapy. CT Scan showed hydrocephalus and granuloma lesion. Emergency ventriculoperitoneal shunting were performed. During treatment, the patient developed paroxysmal sympathetic syndrome during treatment that was controlled based on symptom elimination and prevention. CLINICAL DISCUSSION: Brain tuberculosis remains a difficult problem for clinicians. Even when antitubercular drugs are administered according to protocol, paradoxical reactions can occur. If hydrocephalus develops, ventriculoperitoneal shunting is one of the options for lowering intracranial pressure. Paroxysmal sympathetic hyperactivity may occur in brain tuberculosis and should be detected as soon as possible to avoid serious morbidity. CONCLUSION: Paroxysmal sympathetic hyperactivity may be developed in brain tuberculosis. Early identification and treatment are mandatory.
Authors: Juan Francisco Fernandez-Ortega; Miguel Angel Prieto-Palomino; Manuel Garcia-Caballero; Juan Luis Galeas-Lopez; Guillermo Quesada-Garcia; Ian J Baguley Journal: J Neurotrauma Date: 2012-02-22 Impact factor: 5.269
Authors: Katherine A Kirk; Michael Shoykhet; Jong H Jeong; Elizabeth C Tyler-Kabara; Maryanne J Henderson; Michael J Bell; Ericka L Fink Journal: Dev Med Child Neurol Date: 2012-06-19 Impact factor: 5.449
Authors: Lidya Chaidir; Carolien Ruesen; Bas E Dutilh; Ahmad R Ganiem; Anggriani Andryani; Lika Apriani; Martijn A Huynen; Rovina Ruslami; Philip C Hill; Reinout van Crevel; Bachti Alisjahbana Journal: J Glob Antimicrob Resist Date: 2018-08-29 Impact factor: 4.035
Authors: Ian J Baguley; Roxana E Heriseanu; Ian D Cameron; Melissa T Nott; Shameran Slewa-Younan Journal: Neurocrit Care Date: 2008 Impact factor: 3.210
Authors: Jeremiah Chakaya; Mishal Khan; Francine Ntoumi; Eleni Aklillu; Razia Fatima; Peter Mwaba; Nathan Kapata; Sayoki Mfinanga; Seyed Ehtesham Hasnain; Patrick D M C Katoto; André N H Bulabula; Nadia A Sam-Agudu; Jean B Nachega; Simon Tiberi; Timothy D McHugh; Ibrahim Abubakar; Alimuddin Zumla Journal: Int J Infect Dis Date: 2021-03-11 Impact factor: 3.623