European Journal of Cardiovascular Medicine

Background:  Neurotuberculosis, particularly tuberculous meningitis (TBM), poses a significant threat to pediatric populations, often leading to severe morbidity and mortality. Timely diagnosis and intervention are critical for improved outcomes. Neuroimaging, including CT and MRI, play a crucial role in identifying characteristic features of TBM, such as basal hyperdensities, hydrocephalus, and periventricular infarcts. Transcranial Doppler (TCD) is an emerging tool, offering real-time, non-invasive assessment of cerebral hemodynamics. Limited research has explored the role of TCD in TBM-related vasculopathy. Methodology: A prospective study conducted from August 2019 to July 2020 included 60 pediatric TBM patients. Diagnosis followed the Consensus clinical case definition. TCD was performed serially on days 1, 3, and 7, and findings were compared with CT. Disease severity was graded using the Modified British Medical Research Council (MRC). Statistical analysis was performed with a significance level set at p < 0.05. Results: The study identified a positive correlation between TCD findings and disease stage, with 52.5% of subjects exhibiting normal Doppler studies. Abnormal findings included stenosis in 37% of cases, primarily involving the middle cerebral artery (MCA). The correlation between TCD and CT angiography (CTA) was highly positive, with TCD demonstrating a sensitivity of 91.7%, specificity of 85.7%, and overall accuracy of 87.5%. Discussion: The findings underscore TCD's effectiveness in early diagnosis and monitoring of cerebral vasculopathy in pediatric TBM, particularly in identifying stenotic areas. The positive correlation between TCD and disease stage supports its utility as a reliable tool in assessing disease progression.