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She received thrombolytic treatment for ischaemic stroke. NIHSS improved to 3 with no immediate complications. Following admission, she developed swinging fever, seizures and fluctuating right-sided weakness. Repeat MRI of the head showed leptomeningeal enhancement. Biopsy of the cervical lymph nodes showed histiocytic granulomatous lymphadenitis, which was suggestive of tuberculous meningitis (TBM). She was treated with quadruple antimicrobial therapy and steroids for TBM, as well as aspirin for ischaemic stroke, which resulted in good clinical improvement.<\/jats:p>","DOI":"10.1136\/bcr-2023-259376","type":"journal-article","created":{"date-parts":[[2025,1,19]],"date-time":"2025-01-19T20:50:25Z","timestamp":1737319825000},"page":"e259376","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Stroke thrombolysis in tuberculous meningitis"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3446-9856","authenticated-orcid":false,"given":"Pik Ee","family":"Chan","sequence":"first","affiliation":[{"name":"Geriatric medicine, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anamika","family":"Saha","sequence":"additional","affiliation":[{"name":"Great Western Hospital Foundation NHS Trust, Swindon, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Saunders","sequence":"additional","affiliation":[{"name":"Great Western Hospital Foundation NHS Trust, Swindon, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel SC","family":"Yiin","sequence":"additional","affiliation":[{"name":"Neurology Department, Singapore General Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,19]]},"reference":[{"key":"2025082802043738000_18.1.e259376.1","unstructured":"World Health Organization . 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