Magnetic Resonance Imaging in Diagnosis of Childhood Central Nervous System Tuberculosis

Uysal, Gülnar; Köse, Gülşen; Güven, Akif; Diren, B.

doi:10.1007/s15010-001-2014-9

Cited by 36 publications

(28 citation statements)

References 13 publications

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“…Clinical involvement of the cranial nerves has been reported in 17.4-70% of patients with CNS-TB [10] . Cranial nerve involvement without specific MR findings observed in our sample might be related to the ischemic changes of the cranial nerve nuclei or peripheral segments.…”

Section: Resultsmentioning

confidence: 99%

“…Imaging techniques have recently been revealed as important diagnostic tools as they can demonstrate various conditions, such as intracranial tuberculomas, edema, ventricular dilatation and basal cistern enhancement [8,9] . Contrast-enhanced MR imaging is generally the preferred procedure to detect and assess CNS tuberculosis [10] . As CNS-TB is often clinically indolent and early treatment is necessary to avoid a fatal outcome, our aim was to seek to improve the diagnosis of the disease.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Features in Tubercular Meningoencephalitis Diagnosis: 18 Childhood Cases

Carlo¹,

Cabibi²,

Casuccio³

et al. 2008

American J. of Infectious Diseases

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Abstract:The aim of this research is to illustrate clinical and instrumental features of central nervous system tuberculosis (CNS-TB) in childhood in order to allow prompt diagnosis and adequate patient management. TB remains one of the most important communicable diseases and represents a major global health problem. Although pulmonary TB tends to be the most common form of the disease, the highest mortality and morbidity occurs with TB of the central nervous system (CNS-TB), which develops in 4% of children with tuberculosis. It has a high fatality rate and causes serious sequelae, especially during childhood. CT and MR imaging studies of 18 patients (11 female, 7 male, mean age 45.72 months) were retrospectively reviewed. A basilar enhancement was detected in all the patients. Other findings were hydrocephalus (61%), intracranial tuberculomas (17%) other nodular (11%) and ischemic lesions (11%). Edema, either perilesional or diffuse, was found in 7/18 patients. Severe ventricular dilatation was observed in 9/18 cases. Two patients with fatal outcome had severe hydrocephalus associated with extensive ischemic areas in one case and intraventricular haemorrhage in the other. Cross-sectional imaging, together with clinical data, may provide useful clues for the early diagnosis of CNS-TB and help to prevent unnecessary morbidity and mortality.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Features in Tubercular Meningoencephalitis Diagnosis: 18 Childhood Cases

Carlo¹,

Cabibi²,

Casuccio³

et al. 2008

American J. of Infectious Diseases

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“…Isoniazid-resistant TB was proved in 6% of 1896 TBM patients and could increase the mortality. 18) Another possibility may be the lower transfer rate of the anti-TB agents into CSF. However, isoniazid freely passes into CSF, and the other two agents can enable penetrate under inflammatory conditions.…”

Section: Discussionmentioning

confidence: 99%

“…However, isoniazid freely passes into CSF, and the other two agents can enable penetrate under inflammatory conditions. 18) Although recent reports indicate the efficacy of corticosteroid infusion 3,15) for TBM, the effect may be restricted and ameliorate mortality but not morbidity. 16) Further study is required to establish the second line of treatment if TBM is resistant to anti-TB agents and corticosteroid administration.…”

Section: Discussionmentioning

confidence: 99%

Fulminant Tuberculous Meningitis

Shinoyama

Suzuki

Nomura

2012

Neurol. Med. Chir.(Tokyo)

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A 56-year-old Japanese male presented with tuberculous meningitis (TBM) manifesting as irrational behavior. He underwent lumbar puncture, which showed inflammatory cerebrospinal fluid (CSF) findings. Administration of anti-tuberculosis (TB) agents was started on the day after admission (Day 1) because delayed treatment of TBM might be fatal. On Day 4, magnetic resonance (MR) imaging and MR angiography showed fresh infarctions, hydrocephalus, and stenoses of arteries. CSF drainage and biopsy of brain tissue were performed, but the pathological findings were non-specific. Frequent CSF examinations, cultures, and polymerase chain reaction were performed, but no positive finding of TB was obtained. He died on Day 14. Brain autopsy showed Langerhans giant cells and Ziehl-Neelsen-positive TB bodies. Unfortunately, our patient suffered very poor outcome irrespective of early anti-TB treatment starting Day 1, suggesting the probability of delayed admission or drug-resistant TB. TB infection including TBM has become rare in developed countries, and diagnosis remains difficult. Corticosteroid therapy may be effective for TBM, but may be restricted and ameliorate mortality but not morbidity. Further study is required to establish second line treatment if TBM is resistant to anti-TB agents and corticosteroid administration.

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“…3 280 40% children, age not specified Salgado et al 4 6 Mean=30(15-3years) Chang et al 7 26 5-65 years Uysal et al 5 11 Median age=6 years Present study 75 5-66 years In a study conducted by Salgado et al 4 on 6 patients, male-to-female ratio is 1:2.…”

Section: Seriesmentioning

confidence: 91%

Spectrum of Intracranial Tuberculosis on Magnetic Resonance Imaging

S¹,

Sreevani²

2016

jemds

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BACKGROUNDTuberculosis (TB) of the Central Nervous System (CNS) is a common infection, especially in the underdeveloped and developing countries accounting for a major health problem. Its incidence is on rise in developed nations too with the emergence of AIDS. A common manifestation of CNS tuberculosis is leptomeningitis, while other manifestations of CNS-TB are focal parenchymal granulomas (eg: tuberculomas), tuberculous abscesses, tuberculous cerebritis and pachymeningitis.

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Magnetic Resonance Imaging in Diagnosis of Childhood Central Nervous System Tuberculosis

Cited by 36 publications

References 13 publications

Features in Tubercular Meningoencephalitis Diagnosis: 18 Childhood Cases

Features in Tubercular Meningoencephalitis Diagnosis: 18 Childhood Cases

Fulminant Tuberculous Meningitis

Spectrum of Intracranial Tuberculosis on Magnetic Resonance Imaging

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