Rare Presentation of Central Nervous System Tuberculosis with Bilateral Anterior Cerebral Artery Aneurysm: A Case Report

Abstract

Central Nervous System tuberculosis (CNS TB) with intracranial aneurysms is rare and needs prompt diagnosis and early management. The presence of un-ruptured or ruptured aneurysms in the presence of CNS infection is difficult to treat in both acute settings and long-term management because of possible complications prevention. A female of 70 years of age presented with a history of fever, headache, vomiting, and altered sensorium for one week with GCS of 13/15, later developing paraparesis. She was diagnosed to  have CNS tuberculosis with complicating bilateral anterior communicating artery (ACA) aneurysms. She was managed conservatively in our hospital and was referred for endovascular neurosurgical intervention for the aneurysms to another center because of non-availability in our setup. CNS infection with intracranial aneurysms is difficult to manage and such a combination of vascular complications of tuberculous meningitis must be kept in mind while dealing with such scenarios but carries a good prognosis if diagnosed and managed as early as possible to avoid complications.