Central Nervous System Tuberculosis

Abstract

Tuberculosis (TB) has shown a resurgence in nonendemic populations in recent years and accounts for 8 million deaths annually in the world. Central nervous system involvement is one of the most serious forms of this infection, acting as a prominent cause of morbidity and mortality in developing countries. The rising number of cases in developed countries is mostly attributed to factors such as the pandemic of acquired immunodeficiency syndrome and increased migration in a globalized world. Mycobacterium TB is responsible for almost all cases of tubercular infection in the central nervous system. It can manifest in a variety of forms as tuberculous meningitis, tuberculoma, and tubercular abscess. Spinal infection may result in spondylitis, arachnoiditis, and/or focal intramedullary tuberculomas. Timely diagnosis of central nervous system TB is paramount for the early institution of appropriate therapy, because delayed treatment is associated with severe morbidity and mortality. It is therefore important that physicians and radiologists understand the characteristic patterns, distribution, and imaging manifestations of TB in the central nervous system. Magnetic resonance imaging is considered the imaging modality of choice for the study of patients with suspected TB. Advanced imaging techniques including magnetic resonance perfusion and diffusion tensor imaging may be of value in the objective assessment of therapy and to guide the physician in the modulation of therapy in these patients.

Magnetic resonance imaging spectrum of intracranial tubercular lesions: one disease, many faces

“…Tuberculosis (TB) is a devastating disease caused by Mycobacterium tuberculosis with over eight million deaths reported annually worldwide from direct or indirect consequences of the disease [1]. It has shown a resurgence in recent years even in non-endemic areas with the advent of acquired immunodeficiency syndrome (AIDS), with 9272 cases of TB reported in USA in 2016 [2].…”

Comparison of Fluorine(18)-fluorodeoxyglucose and Gallium(68)-citrate PET/CT in patients with tuberculosis

“…Intracranial TB is associated with higher mortality rates than other forms of TB [19]. Objective assessment of therapy to guide clinicians in the management is essential [20]. The ability of PET to quantify disease burden using semi-quantitative indices makes it a particularly useful imaging technique for monitoring therapy.…”

Streptococcus pneumoniae meningitis complicated by an intramedullary abscess: a case report and review of the literature

“…Many case reports have described the formation of intramedullary abscess in patients with active tuberculosis infection or Mycobacterium tuberculosis in the purulent fluid in the abscess [ 22 – 30 ]. Most of these patients had a good recovery after surgery and the initiation of antituberculosis medications.…”