{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1390282679615807616.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.3995/jstroke.29.635"}},{"identifier":{"@type":"NAID","@value":"130004542909"}},{"identifier":{"@type":"URI","@value":"https://search.jamas.or.jp/link/ui/2008012645"}}],"dc:title":[{"@language":"en","@value":"Cerebral infarction due to tuberculous meningitis with MCA occlusion demonstrated by chronological MRA"},{"@language":"ja","@value":"経時的ＭＲＡで主幹動脈の閉塞を認めた結核性髄膜炎による脳梗塞"}],"dc:language":"ja","description":[{"type":"abstract","notation":[{"@language":"en","@value":"We report a case of a patient with cerebral infarction due to tuberculous meningitis with occlusion of the MCA demonstrated by chronological MRA. A 65-year-old male developed headache and loss of activity for 2 weeks. On admission, neurological evaluations revealed confusion of the consciousness state, meningeal irritation, exaggerated deep tendon reflexes in all four extremities and positive bilateral Babinski reflexes. The cerebrospinal fluid cell count was 271/mm<sup>3</sup>, protein was 166mg/d<i>l</i>, and ADA was 15.9IU/<i>l</i>. Bacterial and acid-fast bacterial cultures of the cerebrospinal fluid were negative. <i>Mycobacterium tuberculosis</i> DNA detection by PCR was positive. Brain MRI and MRA showed normal aging signs. Chest X-ray and CT examinations revealed normal findings. The diagnosis was tuberculous meningitis. Anti-tuberculosis chemotherapy and steroids improved his symptoms. After 4 weeks, the steroid treatment was reduced gradually. At 45 days after admission, a brain MRI scan showed infarction of the right basal ganglia. At 56 days, another brain MRI scan showed infarction of the left middle cerebral artery, and brain MRA revealed occlusion of the left middle cerebral artery. The neurological sequela was tetraparesis. This patient represents a rare case of occlusive change of the MCA demonstrated by MRA before and after infarction. Evidence based medicine should be investigated concerning the dose and period of corticosteroid for the treatment of tuberculous meningitis."},{"@language":"ja","@value":"症例は65歳男性. 主訴は頭痛と嘔吐, 意識障害. 2週間前から頭痛と嘔吐がつづき, 徐々に言葉数が少なくなり入院. 意識はJCSでI-3, 髄膜刺激徴候を認めた. 入院時の頭部MRI, MRAは異常なし. 髄液検査は細胞数増多, 蛋白上昇, ADA上昇, 結核菌DNA (PCR) 陽性. 胸部CTは異常なし. 結核性髄膜脳炎と診断し, ステロイドを併用しながら抗結核療法を開始した. 症状は徐々に改善したため, ステロイドは開始して4週間後から漸減した. 入院45日目に右放線冠梗塞, 入院56日目に左MCA領域の梗塞をきたし, 頭部MRAで左MCA閉塞を認めた. 以後, 四肢麻痺が残存した. 結核性髄膜炎による脳梗塞において発症前後で脳血管の変化を捉えた報告は非常に少ない. 結核性髄膜炎では良好な経過中でも主幹動脈の閉塞から脳梗塞をきたすことがあり十分な注意が必要と考えた."}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410001204870588801","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000014116206"},{"@type":"NRID","@value":"9000365523957"},{"@type":"NRID","@value":"9000014025340"},{"@type":"NRID","@value":"9000021702332"},{"@type":"NRID","@value":"9000365523918"},{"@type":"NRID","@value":"9000288799178"},{"@type":"NRID","@value":"9000013877885"},{"@type":"NRID","@value":"9000022057818"},{"@type":"NRID","@value":"9000252876665"},{"@type":"NRID","@value":"9000256346231"},{"@type":"NRID","@value":"9000327927732"},{"@type":"NRID","@value":"9000288799161"},{"@type":"NRID","@value":"9000018209396"},{"@type":"NRID","@value":"9000389964524"},{"@type":"NRID","@value":"9000399564356"},{"@type":"NRID","@value":"9000327927846"},{"@type":"NRID","@value":"9000020580988"},{"@type":"NRID","@value":"9000365523941"},{"@type":"NRID","@value":"9000399169310"},{"@type":"NRID","@value":"9000242154359"},{"@type":"NRID","@value":"9000402903108"},{"@type":"NRID","@value":"9000345220049"},{"@type":"NRID","@value":"9000412266645"},{"@type":"NRID","@value":"9000389964541"},{"@type":"NRID","@value":"9000406033188"},{"@type":"NRID","@value":"9000000756297"},{"@type":"NRID","@value":"9000020274785"},{"@type":"NRID","@value":"9000258213606"},{"@type":"NRID","@value":"9000365523907"},{"@type":"NRID","@value":"9000020169839"},{"@type":"NRID","@value":"9000021325325"},{"@type":"RESEARCHMAP","@value":"https://researchmap.jp/read0152895"}],"foaf:name":[{"@language":"en","@value":"Tanaka Yuji"},{"@language":"ja","@value":"田中 優司"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Neurology and Geriatrics, Division of Neuroscience, Graduate School of Medicine, Gifu University"},{"@language":"ja","@value":"岐阜大学大学院医学系研究科医科学専攻神経統御学講座神経内科・老年学分野"},{"@language":"en","@value":"Department of Neurology, Gifu Prefectural General Medical Center"},{"@language":"ja","@value":"岐阜県総合医療センター神経内科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410572172434926210","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000258213607"}],"foaf:name":[{"@language":"en","@value":"Nishida Hiroshi"},{"@language":"ja","@value":"西田 浩"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"岐阜県総合医療センター神経内科"},{"@language":"en","@value":"Department of Neurology, Gifu Prefectural General Medical Center"}]},{"@id":"https://cir.nii.ac.jp/crid/1030003658483471616","@type":"Researcher","personIdentifier":[{"@type":"KAKEN_RESEARCHERS","@value":"50184734"},{"@type":"NRID","@value":"1000050184734"},{"@type":"NRID","@value":"9000000982824"},{"@type":"NRID","@value":"9000345193180"},{"@type":"NRID","@value":"9000365523967"},{"@type":"NRID","@value":"9000283523065"},{"@type":"NRID","@value":"9000021702336"},{"@type":"NRID","@value":"9000365510917"},{"@type":"NRID","@value":"9000365523920"},{"@type":"NRID","@value":"9000022057820"},{"@type":"NRID","@value":"9000267847668"},{"@type":"NRID","@value":"9000331090473"},{"@type":"NRID","@value":"9000018802721"},{"@type":"NRID","@value":"9000283542223"},{"@type":"NRID","@value":"9000334738135"},{"@type":"NRID","@value":"9000007737318"},{"@type":"NRID","@value":"9000412604308"},{"@type":"NRID","@value":"9000254355630"},{"@type":"NRID","@value":"9000240055629"},{"@type":"NRID","@value":"9000283542217"},{"@type":"NRID","@value":"9000006007516"},{"@type":"NRID","@value":"9000273000082"},{"@type":"NRID","@value":"9000002126988"},{"@type":"NRID","@value":"9000002444231"},{"@type":"NRID","@value":"9000312726584"},{"@type":"NRID","@value":"9000254505889"},{"@type":"NRID","@value":"9000397799383"},{"@type":"NRID","@value":"9000283542202"},{"@type":"NRID","@value":"9000283523246"},{"@type":"NRID","@value":"9000334737973"},{"@type":"NRID","@value":"9000020274835"},{"@type":"NRID","@value":"9000258213608"},{"@type":"NRID","@value":"9000365523912"},{"@type":"NRID","@value":"9000258059204"},{"@type":"NRID","@value":"9000241434491"},{"@type":"NRID","@value":"9000020169861"},{"@type":"NRID","@value":"9000021325345"},{"@type":"RESEARCHMAP","@value":"https://researchmap.jp/read0009212"}],"foaf:name":[{"@language":"en","@value":"Inuzuka Takashi"},{"@language":"ja","@value":"犬塚 貴"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"岐阜大学大学院医学系研究科医科学専攻神経統御学講座神経内科・老年学分野"},{"@language":"en","@value":"Department of Neurology and Geriatrics, Division of Neuroscience, Graduate School of Medicine, Gifu University"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"09120726"},{"@type":"LISSN","@value":"09120726"},{"@type":"EISSN","@value":"18831923"}],"prism:publicationName":[{"@language":"en","@value":"Japanese Journal of Stroke"},{"@language":"ja","@value":"脳卒中"},{"@language":"en","@value":"Nosotchu"},{"@language":"en","@value":"Jpn. J. Stroke"},{"@language":"ja","@value":"脳卒中"}],"dc:publisher":[{"@language":"en","@value":"The Japan Stroke Society"},{"@language":"ja","@value":"一般社団法人 日本脳卒中学会"}],"prism:publicationDate":"2007","prism:volume":"29","prism:number":"5","prism:startingPage":"635","prism:endingPage":"641"},"reviewed":"false","url":[{"@id":"https://search.jamas.or.jp/link/ui/2008012645"}],"availableAt":"2007","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=tuberculous%20meningitis","dc:title":"tuberculous meningitis"},{"@id":"https://cir.nii.ac.jp/all?q=cerebral%20infarction","dc:title":"cerebral infarction"},{"@id":"https://cir.nii.ac.jp/all?q=corticosteroid","dc:title":"corticosteroid"},{"@id":"https://cir.nii.ac.jp/all?q=artery%20occlusion","dc:title":"artery occlusion"},{"@id":"https://cir.nii.ac.jp/all?q=MRA","dc:title":"MRA"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360011145693336704","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Randomized controlled trial of dexamethasone in tuberculous meningitis"}]},{"@id":"https://cir.nii.ac.jp/crid/1360016870541605504","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"PATHOLOGY AND PATHOGENETIC MECHANISMS IN NEUROTUBERCULOSIS"}]},{"@id":"https://cir.nii.ac.jp/crid/1360855568877937664","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"MR imaging and angiography in tuberculous meningitis"}]},{"@id":"https://cir.nii.ac.jp/crid/1361137044000557440","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Dexamethasone adjunctive treatment for tuberculous meningitis"}]},{"@id":"https://cir.nii.ac.jp/crid/1361418518612875648","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Tuberculous Meningitis"}]},{"@id":"https://cir.nii.ac.jp/crid/1361418520887517440","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"The Angiographic Triad in Tuberculous Meningitis"}]},{"@id":"https://cir.nii.ac.jp/crid/1361699996439458944","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Effect of Corticosteroids on Intracranial Pressure, Computed Tomographic Findings, and Clinical Outcome in Young Children With Tuberculous Meningitis"}]},{"@id":"https://cir.nii.ac.jp/crid/1362262943642022784","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Vasculitides Associated with Infections, Immunization, and Antimicrobial Drugs"}]},{"@id":"https://cir.nii.ac.jp/crid/1362262943738781952","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Ischemic infarction in 25 children with tuberculous meningitis."}]},{"@id":"https://cir.nii.ac.jp/crid/1362544418827625472","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Dexamethasone for the Treatment of Tuberculous Meningitis in Adolescents and Adults"}]},{"@id":"https://cir.nii.ac.jp/crid/1362544421080276096","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Central nervous system tuberculosis in Australia: a report of 22 cases"}]},{"@id":"https://cir.nii.ac.jp/crid/1363388843385113088","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Computed Tomography of Granulomatous Basal Arachnoiditis"}]},{"@id":"https://cir.nii.ac.jp/crid/1364233269308722560","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Predictive value of digital subtraction angiography in patients with tuberculous meningitis"}]},{"@id":"https://cir.nii.ac.jp/crid/1390282679613888384","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@language":"en","@value":"Tuberculous meningitis with unilateral tuberothalamic artery territory infarction."},{"@value":"Ｔｕｂｅｒｏｔｈａｌａｍｉｃ　ａｒｔｅｒｙ領域梗塞を来した結核性髄膜炎"}]}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:0030114678"},{"@type":"CROSSREF","@value":"10.3995/jstroke.29.635"},{"@type":"CIA","@value":"130004542909"}]}