18 mnth after tb meningitis her ct scan says diffuse atrophic changes in d bilateral cerebral hemisphere with large hypodensity in lft internal capsule, she's 23 and hs spasm in limbs. any hope?

Mgt/workup: The TB appears to have spread and may be difficult to treat. I would suggest that they obtain CSF cultures for TB with sensitivities to guide the multi-drug therapy. The head CT scan can then be followed once she is on targeted therapy. Checking for a pulmonary source and a screening chest XR The spasm of her limbs may be from a prior episode of encephalitis based on her history.