Turkish Journal of Medical SciencesEvaluation of radiological findings in 160 adult patients with tuberculous meningitis
1 Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, İstanbul - TURKEY
2 Department of Neurosurgery, İstanbul Training and Research Hospital, İstanbul - TURKEY
Abstract: To evaluate the radiological findings of 160 adult patients with tuberculous meningitis (TBM). Materials and methods: Using a standard data collection form, 160 patients with TBM who had been followed for 11 years were assessed retrospectively. Cranial imaging results were obtained by computed tomography (CT) and magnetic resonance imaging (MRI), and pulmonary findings were obtained by chest X-ray and CT. Tuberculomas were assessed with a nominal tuberculoma classification index (TCI) scale. Results: Of the 160 patients, 80 were males and the mean age was 32.18 ± 13.62 years (range: 14-78). On admission, 84% were in stages II or III; 27 of them died (17%) and 20 had neurological sequelae (13%). Active pulmonary tuberculosis (TB) presence was significantly higher in the deceased patients than in the survivors (P = 0.019). Tuberculoma (37%), basal meningitis (27%), and hydrocephalus (21%) were the most frequent signs found in the cranial CT or MRI scans, and tuberculomas were mostly multiple and <1 cm according to the TCI. Conclusion: Neuroimaging techniques are useful parameters in the early diagnosis of TBM. In particular, MRI provides specific findings for defining TBM, such as tuberculoma, basal meningitis, or hydrocephalus. The TCI may be useful in defining, following, and comparing the features of tuberculomas as a standard nominal scale.
Key words: Tuberculous meningitis, tuberculosis, MRI, pulmonary tuberculosis, M. tuberculosis, tuberculoma, hydrocephalus
Turk J Med Sci 2012; 42(2): 259-267.
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