Kalita et al reported modification of the British Medical Research Council (BMRC) stages for tuberculous meningitis. One modification adds the need for mechanical ventilation and a second adds the presence of hydrocephalus. The authors are from Sanjay Gandhi Post Graduate Institute of Medical Sciences and Banaras Hindu University in India.
The basic BMRC has 3 stages: I, II and III.
The BMRC-MV staging system adds mechanical ventilation (MV) as Stage IV.
The BMRC-HC staging system adds hydrocephalus (HC) seen on CT or MRI head scans as Stage IV.
The BMRC-MV staging system was predictive of death and disability.
(1) BMRC Stage IV was 88% sensitive and 86% specific for death.
(2) BMRC Stages I to III were associated with a good outcome (modified Rankin Scale <= 2).
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