Tuberculous meningitis—a CT study

Abstract

This study comprises 60 cases of tuberculous meningitis including both adults and children. Only three cases showed a normal scan. Severe hydrocephalus was present in 87.09% children and only 12.09% adults. The incidence of hydrocephalus increased with the duration of the illness and decreased with age. Exudates in the basal cisterns were graded from mild to severe, the latter being seen only in children. Visible infarcts were shown in 28.33% of cases, 10% showed associated parenchymal tuberculomas. Serial follow-up scans indicate that patients with non-enhancing exudates have a good prognosis when medically treated, whereas in those cases with enhancing exudates the prognosis is poor in spite of medical treatment and surgical shunting; they either succumb to their illness or are left with irreversible sequelae. CT has proved sensitive in both the diagnosis and prognosis in clinically suspected tuberculous meningitis.

A Study of CT Findings in children with neurotuberculosis

“…However in the study by Piennar 12 70% of the patients had infarcts on CT. Most infarcts in our series were in the MCA territory similar to that reported by Bhargava et al 21 , however they also had involvement of the PCA territory. Infarcts in the PCA territory are picked up better by MRI.…”

“…The occurrence of tuberculoma in our series correlated well with other studies. 13,18,21 The CSF analysis in about 70% patients with tuberculoma in our study was normal, which highlights the importance of CT in the diagnosis of TBM.…”

“…Similar observation was made by Kumar et al 18 Other studies had a higher occurrence of basal exudates than ours. 12,21 Hydrocephalus is the most frequent complication of TBM and is generally more prominent in the pediatric age group. 9 Most studies had a high occurrence of hydrocephalus and it was also the commonest feature seen on CT, 5,12,20,21 whereas our study had a significantly low occurrence at 33.33%.…”

Adenosine deaminase and C-reactive protein in cerebrospinal fluid for differential diagnosis of tubercular meningitis in children

“…With the use of CSF-ADA, one can pick up early cases of TBM, a conclusion akin to that drawn by Misra et al (12). Studies by Seth et al (15) and Bhargava et al (16) showed similar findings in terms of CT scan findings in TBM patients.…”

Intraventricular Tuberculoma. Case Report.

“…Ventricular involvement in the tuberculous process occurs as choroid plexus inflammation characterized by a covering of gelatinous exudates, ependymitis, and asymmetric hydrocephalus secondary to intraventricular adhesions or septae formation. 1,2,4,5,12) Tubercles (Rich foci) have been found within the choroid plexus, but well-developed intraventricular tuberculoma are extremely rare. Four cases of large intraventricular tuberculoma were found in children.…”