Clinical and radiological spectrum of intracranial tuberculosis: A hospital based study in Northeast India

Synmon, Baiakmenlang; Das, Manas; Kayal, Ashok K; Goswami, Munindra; Sarma, Jogesh; Basumatary, Lakshya J; Bhowmick, Suvorit Subhas

doi:10.1016/j.ijtb.2016.11.011

Cited by 16 publications

(14 citation statements)

References 34 publications

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“…The association of HIV/ AIDS is currently responsible for rising prevalence of tuberculosis worldwide but in Pakistan this factor seems to be a negligible entity besides tuberculosis is the most common infectious cause of CNS space-occupying lesion [13][14][15][16][17] . As concordance with previous studies, the presentation of tuberculoma is increased many folds, if it has been seen in relation to time duration, Wasay M et al 5 highlighted 202 cases in 10 years and Synmon B et al 4 included 28.6% out of 93 included patients in two years, in contrast to this study which reported 20 cases in six months. Younger age patients mostly male preponderance are highly susceptible to tuberculoma and it mostly associated with meningitis (80%), seizures (60%) and history of tuberculosis (60%) which includes primary organ involvement .i.e.…”

Section: Discussionsupporting

confidence: 91%

“…In regard to the associated radiological pathologies of tuberculoma, previous studies showed hydrocephalus, infarcts and edema which is concordance in this study which is the validation of pure presentation of these factors, especially edema (55%) and calcifications (10%), which is considered a rare phenomenon of tuberculoma 4,5,20 . As this study included the cases which seem to be tuberculoma and diagnosed on the basis of high suspicion, empirical treatment, evaluation of patient with detailed examinations, CSF findings, diagnosis of exclusion and multi discipline discussions for non typical cases but this only represents the cases that were referred for advance investigations.…”

Section: Discussionsupporting

confidence: 90%

“…1% with 15-33% present as a multiple lesions 2,3 . Previously a single 10 year, retrospective study showed the total of 202 cases with tuberculoma associated with CNS tuberculosis as compared to two year prospective study, which included 93 patients with 28.6% had radiological characteristics of tuberculoma, showing the increment in manifestation of tuberculoma involving central nervous system in Sub-continent region 4,5 . The presentation of Tuberculoma is usually depends upon nature, distribution, site, number and rate of its increasing size, in adults supratentorial location is common as compared to children where infratentorial is much more prevalent [6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

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Tuberculoma Brain and its Early Radiological Presentation; Descriptive Analytical Study

2019

J Liaquat Uni Med Health Sci

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OBJECTIVE: To highlight the radiological presentation of tuberculoma brain in association with clinical features of the disease METHODOLOGY: As Descriptive analytical nature of study, it was held in Radiology Department of liaquat University Hospital Hyderabad from June 2018 to December 2018. The cases were referred from medicine and neurosurgery ward to the radiology department for MRI and CT scans. The fillings of questionnaire and co relation of its radiological findings with clinical aspect were examined by evaluating patients file and diagnosed on clinical suspicion, CSF findings, improvement on empirical treatment, diagnosis of exclusion and multi discipline discussion. RESULTS: Total numbers of 20 patients were included, mostly younger age were affected with male preponderance. Mostly cases were presented with meningitis (80%), seizures (60%) and history of tuberculosis (60%). On CT and MRI brain scan, the most common findings were multiple lesions (95%) showed central hyper-intensity on T2 (55%) with meningeal enhancement (80%), fluid-attenuate inversion recovery (FLAIR) signals (35%) and hypo-intense core with hyper-intense rim (30%) reflecting the most of cases with early non caseating nature of tuberculoma. Ring like lesions (80%) and irregular shape (45%) with (25%) target like lesions were found and associated with edema (55%) and calcifications (10%). CONCLUSION: The presentation of tuberculoma is no more a rare manifestation of infective CNS disease. Early identification on scans with characteristics of early non caseating granuloma can help in prompt diagnosis and treatment which in turn decreased the disabling nature of disease and its progression.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Tuberculoma Brain and its Early Radiological Presentation; Descriptive Analytical Study

2019

J Liaquat Uni Med Health Sci

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“…TBM usually develops several weeks after the initial M. tuberculosis infection. In the pediatric age group, meningitis is a post-primary event and three quarters of patients have other foci of the disease (mainly pulmonary and pleural) [32][33][34][35].…”

Section: Meningitismentioning

confidence: 99%

“…Tiny multiple scattered foci of punctate enhancement in the brain parenchyma are seen, some have a rig-like enhancement while others do not. There is not a caseous component and they are about 2-3 mm in diameter [31,32]. Non-contrast sequences may not show most of the granulomas, and differential diagnosis among other similar imaging diseases such as neurocysticercosis, gliomas, and metastases may be difficult.…”

Section: Miliary Tuberculosismentioning

confidence: 99%

Central nervous system and spinal cord tuberculosis: Revisiting an important disease

et al. 2021

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Global Frequency and Clinical Features of Stroke in Patients With Tuberculous Meningitis

Espiritu

Pascual

2022

JAMA Netw Open

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IMPORTANCE Stroke in tuberculous meningitis (TBM) is associated with significant morbidity and mortality.OBJECTIVE To determine the country-specific, regional, and overall prevalence of stroke among patients with TBM, including their clinical manifestations, stroke locations, and outcomes.EVIDENCE REVIEW This systematic review searched records in MEDLINE by PubMed, Scopus, and EMBASE until July 2020 for relevant articles on the occurrence and characteristics of stroke in TBM.Randomized clinical trials and cohort studies that included a population of patients with TBM were analyzed for clinical manifestations, type of stroke, area of stroke, vascular territory, and outcomes.Studies that did not report the occurrence of stroke, reported as abstract only with no full-texts available, and articles not in English were excluded. The country-specific, regional, and overall frequencies of stroke among patients with TBM were determined; secondary analysis enumerated the summary estimates of the clinical presentations, common locations of stroke, and outcomes. The Murad tool was used to assess methodological quality.FINDINGS From 852 articles identified, 71 studies involving 2194 patients with stroke in TBM were included. The sample size for each study ranged from 17 to 806 patients. The frequency of stroke in TBM showed an estimate of 0.30 (95% CI, 0.26-0.33). The most common clinical manifestations were fever and headache. The lateral striate, middle cerebral, and medial striate arteries were typically affected. The basal ganglia, cortex and lobar, and internal capsule were the frequently involved areas of the brain. The pooled proportions of mortality and poor outcomes were 0.22 (95% CI, 0.16-0.29) and 0.51 (95% CI, 0.37-0.66), respectively. CONCLUSIONS AND RELEVANCEThe results of this systematic review suggest that stroke is considerably frequent among patients with TBM. The reported frequencies of stroke in TBM and its clinical features vary across the studies and populations.

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Clinical and radiological spectrum of intracranial tuberculosis: A hospital based study in Northeast India

Cited by 16 publications

References 34 publications

Tuberculoma Brain and its Early Radiological Presentation; Descriptive Analytical Study

Tuberculoma Brain and its Early Radiological Presentation; Descriptive Analytical Study

Central nervous system and spinal cord tuberculosis: Revisiting an important disease

Global Frequency and Clinical Features of Stroke in Patients With Tuberculous Meningitis

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