Central Nervous System Tuberculosis

Patkar, Deepak; Narang, Jayant; Yanamandala, Rama; Lawande, Malini; Shah, Gaurang

doi:10.1016/j.nic.2012.05.006

Cited by 93 publications

(37 citation statements)

References 89 publications

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“…Tuberculous meningitis predominantly affects the basal meninges and has two patterns: focal nodular , with mass-like thickening of the meninges; or en plaque, with diffuse meningeal thickening [95]. Affected areas are isodense to hyperdense on CT [93].…”

Section: Introductionmentioning

confidence: 99%

Dural masses: meningiomas and their mimics

et al. 2019

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Meningiomas are the most common dural tumour. They are regularly being seen as an incidental finding on brain imaging and treated conservatively. However, there are many other dural masses which mimic their appearances, including primary neoplastic processes, metastases, granulomatous diseases and infection. While some of these are rare, others such as metastases and tuberculosis arise relatively frequently in practice. Although not pathognomonic, key features which increase the probability of a lesion being a meningioma include intralesional calcifications, skull hyperostosis, local dural enhancement and increased perfusion. It is important to have an awareness of these entities as well as their main imaging findings, as they have a wide range of prognoses and differing management strategies. This review outlines several of the most important mimics along with their imaging findings on both standard and advanced techniques with key features which may be used to help differentiate them from meningiomas.

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Section: Introductionmentioning

confidence: 99%

Dural masses: meningiomas and their mimics

et al. 2019

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“…CNS tuberculosis can manifest in a variety of forms, including tuberculous meningitis (the most common presentation), tuberculomas, tuberculous abscesses, tuberculous cerebritis, and miliary tuberculosis ( 1 , 15 ). Tentorial and cerebellar meningeal enhancement are less common ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

“…Communicating hydrocephalus is a secondary imaging finding to obstruction of cerebrospinal fluid flow due to meningeal exudate ( 17 ). Non-communicating (obstructive) hydrocephalus can occur either because of outlet obstruction of the fourth ventricle by the basal exudates or mass effect of a focal parenchymal tuberculoma ( 16 ). The significance of hydrocephalus has been overlooked in cases with no brain parenchymal changes.…”

Section: Discussionmentioning

confidence: 99%

Atypical Cerebral Manifestations of Disseminated Mycobacterium tuberculosis

et al. 2017

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BackgroundWe investigated the patterns of cerebral manifestations in patients with underlying pulmonary or extrapulmonary tuberculosis or disseminated tuberculosis.Materials and methodsFrom January 2010 to September 2016, brain magnetic resonance imaging (MRI) scans were obtained to evaluate cerebral manifestations in patients with underlying pulmonary or extrapulmonary tuberculosis. We also included patients with drug-resistant tuberculosis or disseminated tuberculosis. MRI findings of tuberculous meningitis and tuberculoma were classified as typical; other MRI findings were classified as atypical. Demographic data, risk factors, and drug regimens were collected and analyzed.ResultsTwenty-two patients were diagnosed with cerebral tuberculosis. Cerebral tuberculosis was due to hematogenous spread from pulmonary tuberculosis (10 patients), spinal tuberculosis (8 patients), disseminated tuberculosis (3 patients), and unknown causes (1 patient). There were six patients with typical MRI findings (three patients with typical meningitis involving the basal cistern and supratentorium, one patient with tuberculomas, and two patients with both) and seven patients with atypical MRI findings [five patients with evidence of early meningitis, such as high signal intensity on fluid-attenuated inversion recovery (FLAIR) along the cerebellar folia, and two patients with only hydrocephalus].ConclusionBesides the typical sites of meningeal involvement, overlooked findings such as FLAIR abnormalities along the cerebellar folia or hydrocephalus should be checked for early detection of cerebral tuberculosis and initiation of the appropriate treatment against disseminated tuberculosis.

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“…With the onset of the human immunodeficiency virus pandemic, the incidence of CNS TB has increased [ 5 – 8 ], which accounts for approximately 10% of all patients with AIDS-related TB [ 9 ]. It is no longer a disease confined to underdeveloped and developing countries [ 5 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Cerebral hemorrhage due to tuberculosis meningitis: a rare case report and literature review

Zou

Pan

et al. 2015

Oncotarget

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Tuberculosis (TB) is a common disease to threaten human health. TB of the central nervous system (CNS) is rare but the most serious type of systemic TB because of its high mortality rate, serious neurological complications and sequelae. In this case report, we describe a woman who presented with walking instability, intracerebral hemorrhage and leptomeningeal enhancement due to tuberculosis meningitis. The patient had no significant medical history and the initial clinical symptoms were walking instability. On analysis, the cerebrospinal fluid was colorless and transparent, the pressure was more than 400 mm H2O, there was lymphocytic pleocytosis, increased protein, and decreased glucose levels present. No tuberculosis or other bacteria were detected. The patient's brain computed tomography image showed intra-cerebral hemorrhage (ICH) and contrast magnetic resonance imaging showed ICH in the right frontal lob, and leptomeningeal enhancement. CNS TB is rare but has a high mortality rate. As this disease has no unique characteristics at first presentation such as epidemiology and obvious clinical manifestation, a diagnosis of CNS TB remains difficult.

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Central Nervous System Tuberculosis

Cited by 93 publications

References 89 publications

Dural masses: meningiomas and their mimics

Dural masses: meningiomas and their mimics

Atypical Cerebral Manifestations of Disseminated Mycobacterium tuberculosis

Cerebral hemorrhage due to tuberculosis meningitis: a rare case report and literature review

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