Vascular Endothelial Growth Factor in Tuberculous Meningitis

Vascular endothelial growth factor (VEGF) is linked to brain edema and infarction, but there is paucity of studies correlating VEGF level with magnetic resonance imaging (MRI) changes in tuberculous meningitis (TBM). The aim of this study was to measure serum VEGF level in TBM and correlate it with clinical, laboratory, and MRI findings. Forty patients with TBM underwent cranial evaluation, cranial MRI, and MR angiography (MRA). Presence of exudates, hydrocephalous, infarction, tuberculoma, and MRA abnormalities was noted. Serum VEGF level was measured by enzyme-linked immunosorbent assay and compared in patients and controls. The VEGF level was also correlated with clinical, MRI, and MRA findings. The median age of the patients was 26.5 years. There was a trend towards higher serum VEGF level in TBM patients (100.7 +/- 110.6 pg/ml) compared to the controls (60.6 +/- 20.3 pg/ml). There was also a trend towards higher VEGF level in patients with shorter duration of illness (127.5 +/- 152.4 pg/ml vs 76.5 +/- 40.9 pg/ml), MRI evidence of infarction (131.4 +/- 150.7 pg/ml vs 73.0 +/- 41.4 pg/ml), and paradoxical response (122.3 +/- 157.6 pg/ml vs 88.8 +/- 50.8 pg/ml). Five patients died, and death was not related to VEGF level. It can be concluded that serum VEGF level in TBM patients is insignificantly higher in those with shorter duration of illness and infarction.