When the causative agent of tuberculosis - Koch's bacillus or mycobacterium - spreads outside the lungs and enters the tissues of the nervous system, a brain disease arises.
Most of all patients at the time of this diagnosis already suffered from pathology of the respiratory system. The most severe type of this disease is considered to be tuberculosis of the brain.
Description
Tuberculosis is an infectious pathology of bacterial etiology. The disease has not only a medical, but also a social aspect: the most sensitive to pathogens are people with weakened immune systems, unhealthy diets, and people living in poor sanitary conditions. The origin of this pathology is affected by the quality of human life. However, all sectors of the population, without age or gender restrictions, fall into the risk category for tuberculosis.
Features
The regularity of deaths and the high prevalence of brain tuberculosis is explained not only by social factors, but also by the long period of latent course, when the pathology does not manifest itself and the symptoms are completely absent. It is this time that is considered the most favorable for treatment, and the well-known Mantoux test is used to determine the presence of the pathogen in the body.
Pathogenesis
Brain tuberculosis arises after a person is infected with mycobacterium or Koch's bacillus. This bacterium is resistant to environmental influences, high temperature, maintaining viability for a long time even with its strong fluctuations.
In fact, Koch's wand is not a contagious infectious agent. Despite the fact that its carrier with an open pathology spreads microbes around itself, the chance of infection after contact with the pathogen and its entry into the body in a healthy person is extremely small. A patient with a diagnosis of “brain tuberculosis”, as a rule, does not need in-patient treatment; in the case of an inactive form of the disease, he is absolutely unlimited in his movements. As for constant household contact, in a family whose member is sick with this pathology, it is advisable to pay special attention not only to his state of health, but also to maintaining general hygiene.
Methods of infection
Is brain tuberculosis contagious? The disease affects the central nervous system and the membranes of the main organ when its pathogen moves from the lesion to the bloodstream and then moves on.
Pathology may occur:
- hematogenous;
- lymphogenous;
- perineurally.
As a rule, this occurs by one of these methods from a focus already present in the body. Location may be in:
- kidneys;
- lungs;
- lymph nodes and other organs.
How is pathology transmitted? Microbes can be in the air, ingested. Tuberculosis of the brain is contagious, so a person can become infected during sexual intercourse, alimentarily and through cuts.
In addition, there is a chance of a primary infection. For example, when the cranium is injured and the Koch stick penetrates the meninges.
Who is prone to pathology
The main risk groups for contracting tuberculosis include people who suffer from:
- HIV infections
- drug addiction;
- somatic pathologies.
In addition, those who previously suffered from a traumatic brain injury, underwent surgery, as well as babies with rickets, have a high predisposition. Another high-risk category includes people who abuse alcohol, suffer from malnutrition and malnutrition, as well as people of advanced age.
Causes
There are factors that significantly lower immunity and contribute to the onset of the disease during contact with the carrier. Causes of brain tuberculosis may include:
- smoking tobacco;
- alcohol abuse;
- all varieties of addiction;
- chronic pathologies;
- endocrine diseases, diabetes;
- malnutrition, vitamin deficiency;
- predisposition to pulmonary diseases;
- pregnancy
- depressive states, neurotic failures;
- adverse social conditions.
Varieties of pathology
Tuberculosis bacteria, penetrating the bloodstream, first infect the spinal cord, and then with the flow of cerebrospinal fluid enter the membrane of the brain. The process of bacterial development is quite rapid and it is extremely difficult to prevent it.
There are two forms of brain tuberculosis.
- Meningitis, in which microbes affect the membranes and damage them. Often the development of this form of pathology is accompanied by trauma to other systems and organs.
- Solitary tuberculoma, which is characterized by the location of the focus of infection in the brain stem or cerebellum. As it progresses, pathology generates purulent phenomena and provokes an abscess. As a result, tuberculous spondylitis develops - an injury to the central nervous system.
Classification due to localization
In addition, the disease is divided into several types, depending on the location of the damage:
- with basal tuberculosis, a part of the brain located near the base of the skull is affected;
- the convexital process involves the presence of a focus in the bulges of the brain, with this form, the human consciousness is disturbed;
- meningoencephalitis is called inflammation of the membrane in acute miliary tuberculosis, usually this form of the disease is fatal;
- meningoencephalomyelitis - a parallel inflammation of the spinal cord and brain.
Due to the destruction of the membranes, the walls of the vessels become denser, due to which the blood flow is disturbed, an acute lack of oxygen appears, which causes ischemic disease, in which the tissues of the main organ become soft.
Usually, pathology arises in weakened organisms of people with shaken immunity, HIV disease or AIDS. Knowing the first signs and symptoms of cerebral tuberculosis, the patient is much more likely to resort to specialized TB care at the right time and receive proper treatment. Only in this way can the risks of complications be minimized.
Signs of Brain Tuberculosis
A photo of the symptoms of this disease will help to understand the features of the pathology, its clinical picture and in time to identify such phenomena. Depending on the stage, form of the disease and the localization of its focus, the signs of tuberculosis can manifest themselves in completely different ways.
At the prodromal stage of the patient, repeated short migraines appear at about the same time. With the development of cerebral tuberculosis, the symptom becomes more and more prolonged, and as a result, completely constant. Over time, the patient's sleep is disturbed, he becomes irritable, nervous and conflicting. Noticeable is the general malaise, increased weakness, decreased attentiveness and performance. In this case, the lymph nodes become sore due to inflammation. The duration of this stage can reach two months.
At the stage of irritation, the patient has severe weakness, a significant loss of strength, increased body temperature. Migraines are amplified even more, loud sounds and too bright light unbalance. The digestive system is deteriorating, nausea and vomiting, almost complete lack of appetite. At this stage, the patient’s body weight drops sharply up to the anerixic state. Certain problems with the visual system may occur - decreased sharpness, color and contrast distortion, squint.
The terminal stage develops in case of progression of the pathology and the lack of proper treatment. Symptoms of brain tuberculosis at this stage are manifested in the form of high fever and signs of paralysis, in which the patient may lose consciousness. At the terminal stage, it is almost impossible to achieve a full recovery, in addition, there is a risk of death. But even if the patient manages to escape, he certainly will not be able to return to a full life.
Diagnostics
Since the symptoms of brain tuberculosis are similar to the manifestations of other pathologies of an infectious nature, a patient must undergo a comprehensive examination to accurately confirm the diagnosis. It consists of several main stages.
- MRI, tomography, x-ray - help to detect infectious foci and determine the level of damage to the body. It is noteworthy that on a CT scan of brain tuberculosis you can see an image not only of the surface of the membranes, but also of their inner layers.
- Analysis of biomaterials, which is necessary to check the presence of the pathogen of infection in them. One of the most effective methods for detecting bacteria is PCR.
- Puncture of the spinal cord plays a decisive role in the diagnosis. This procedure allows you to evaluate many important indicators, with particular attention being paid to glucose levels: the more advanced the pathology, the lower its rate.
Disease management
Comprehensive treatment of this type of tuberculosis is carried out only under the supervision of a specialist in an inpatient setting. It takes a long time to restore the body. At this time, the patient may pose a threat to those around him. In addition, the stage of the disease may require constant monitoring by a physician.
First of all, the patient is prescribed a drug regimen for the treatment of brain tuberculosis. It consists of several components:
- vitamins of groups C and B, glutamic acid;
- detoxification and dehydration medications prescribed by a neurologist;
- antipyretic drugs in the presence of an appropriate symptom;
- analgesics are necessary to relieve pain, get rid of migraines;
- anti-TB drugs, which should be taken for at least six months - the most effective are: “Pyrazinamide”, “Ethambutol”, “Isoniazid”, “Rifampicin”.
At a severe stage of pathology, a specialist can prescribe hormonal drugs and symptomatic therapy to the patient, aimed at stabilizing the work of paralyzed muscles, the visual apparatus and other consequences.
In case of treatment failure, surgical intervention is possible. As a rule, the need for surgery occurs at the last stage of the disease to remove the focus of inflammation.
After the diagnosis is established, the patient is placed in a hospital where he must strictly observe bed rest for two months. Only as the general condition of the patient is alleviated and the clinical picture improves, is motor activity gradually resolved. The patient can count on discharge from the hospital only after six months.
Complications
If due to some factors' fault timely diagnosis and therapy have not been carried out, the risk of deleterious effects increases significantly.
A great opportunity to develop such consequences of brain tuberculosis:
- epilepsy;
- hearing impairment;
- relapse of the disease;
- hydrocephalus;
- loss of vision up to complete blindness;
- impossibility of motor activity - a person can remain paralyzed;
- disturbances in the functioning of the central nervous system and a variety of mental disorders.
If therapy is completely absent, irreversible complications progress in the body, due to which an adult can die only a few weeks after infection.
When severe consequences appear, it is almost impossible to completely restore all the body's abilities, and the chances of returning the patient to normal life are extremely small.
But modern medicine, for the most part, provides patients with such a diagnosis with favorable prognoses and many opportunities for complete recovery. In the case of a timely visit to a specialist and correct therapy, avoiding the consequences is not so difficult.
Prevention
To prevent infection with brain tuberculosis should:
- regularly monitor the performance of the Mantoux test;
- undergo BCG revaccination and other mass vaccinations;
- isolate the pathology carrier so that bacteria are not transmitted to healthy people by airborne droplets;
- once during two years it is necessary to undergo a fluorographic examination.