Which of the following is not seen tubercular meinigitis –
**Core Concept**
Tubercular meningitis is a severe infection of the meninges caused by Mycobacterium tuberculosis. It is characterized by inflammation of the meninges, leading to increased intracranial pressure, hydrocephalus, and potentially life-threatening complications.
**Why the Correct Answer is Right**
Tubercular meningitis typically presents with a triad of symptoms: headache, fever, and altered mental status. It is also associated with the presence of tuberculous cerebrospinal fluid (CSF) findings, including elevated protein levels, low glucose levels, and a high lymphocyte count. In contrast to other forms of meningitis, tubercular meningitis often has a delayed presentation, with symptoms developing over several days to weeks.
**Why Each Wrong Option is Incorrect**
**Option A:**
* Incorrect because **vasculitis** is actually a common feature of tubercular meningitis, leading to inflammation of the blood vessels in the brain.
**Option B:**
* Incorrect because **cranial nerve involvement** can occur in tubercular meningitis, particularly affecting cranial nerves II, III, and VI.
**Option C:**
* Incorrect because **seizures** can be a complication of tubercular meningitis, particularly in the context of increased intracranial pressure.
**Option D:**
* Correct because **lymphocytic pleocytosis** is a hallmark of tubercular meningitis, with a predominance of lymphocytes in the cerebrospinal fluid.
**Clinical Pearl / High-Yield Fact**
In tubercular meningitis, the presence of a high CSF protein level (> 1 g/L) is a key diagnostic clue, often accompanied by low glucose levels and a high lymphocyte count.
**Correct Answer:** D. Lymphocytic pleocytosis