Clinical and radiological manifestations of Central Nervous System (CNS) tuberculosis
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 6, Pages 2267-2277
AbstractBackground: Tuberculosis has resurged and remained a major worldwide health problem. Although Mycobacterium tuberculosis can involve any organ, most commonly the lung, central nervous system (CNS) tuberculosis is the most devastating form of the disease. Approximately 5-10% of all patients with tuberculosis and up to 20% of patients with AIDS-related tuberculosis have CNS involvement. Central nervous system (CNS) tuberculosis is a potentially life-threatening condition which is curable if the correct diagnosis is made in the early stages. Its clinical and radiologic manifestations may mimic other infectious and non-infectious neurological conditions. Hence, familiarity with the imaging presentations of various forms of CNS tuberculosis is essential in timely diagnosis, and thereby reducing the morbidity and mortality of this disease.
Aims and Objectives:To Evaluate the clinical and radiological manifestations of Central Nervous System (CNS) tuberculosis.
Material and Methods: Our study was conducted in Department of Radiodiagnosis Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chengalpet,TamilNadu, India and to describe and get familiarized with the imaging characteristics of the different forms of CNS tuberculosis in 50 indoor patients of tuberculosis diagnosed by techniques involving culture and immunological testing of the tissue and biofluids and referred to the department of radio-diagnosis for imaging. Patients with spinal tuberculosis were excluded in our study.
Results and Observations:Males and females contributed 46% and 54% of the study population respectively and in. The age range in years was 10 to 76 years. The mean age of the patients was 28 years with 60% of the patients between 20-40 years. Out of the 50 patients, the commonest presentation was meningitis (82%) especially seen in the younger population-children and adolescents. Early diagnosis of CNS TB is necessary for appropriate treatment and subsequently decreases the morbidity and mortality associated with the disease. Routine diagnostic techniques involve culture and immunological tests of the tissue and biofluids, which are time-consuming and may delay definitive management.
Conclusion: CNStuberculosis has various imaging appearances, including meningitis, tuberculoma, miliary tuberculosis, abscess, cerebritis, and encephalopathy. In addition, the radiologic manifestations of this disease are not always typical and sometimes may be mistaken with other lesions. Familiarity with the various imaging presentations of CNS tuberculosis is of key importance for the radiologists and infectious diseases specialists in timely diagnosis, thereby reducing the morbidity and mortality of this potentially life-threatening disease. Non-invasive imaging modalities such as computed tomography (CT) scan and magnetic resonance imaging (MRI) are routinely used in the diagnosis of neurotuberculosis, with MRI offering greater inherent sensitivity and specificity than CT scan. In this review, we describe the imaging characteristics of the different forms of CNS tuberculosis, including meningitis, tuberculoma, miliary tuberculosis, abscess, cerebritis, and encephalopathy.
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