Central nervous system (CNS) tuberculosis is accepted as the most devastating form of tuberculosis infection. This study aims to review the radiological findings in patients with microbiologically proven CNS tuberculosis.
This study uses CNS tuberculosis patient database provided by the Haydarpasa retrospective multicenter cohort study performed on cases reported from 43 centers in 14 countries. In this study tuberculoma and abscess formation was combined as one bloc as tuberculoma. Accordingly, vasculitis and infact were combined as one bloc as vasculitis.
Out of 507 patients in the database, 444 had CNS imaging at diagnosis. 392 patients were imaged with cranial CT, 284 patients with cranial MRI and 232 patients with both methods. Patients’ mean age was 39.72±18.64 years. There were 230 males (51%). CNS imaging had normal in 124 patients (27.9%). Meningeal involvement in 198 patients (44.6%) which included 98 basal meningitis patients (22% ), hydrocephalus in 118 patients (26.6%), edema in 96 patients (21%), and vasculitis in 72 patients (16%), tuberculoma in 123 patients (27%), cerebritis in 17 patients (3%) were seen. Only seven patients (1%) have spinal tuberculous.
Localization of tuberculomas was reported in 115 patients. Tuberculoma was detected in cerebral hemispheres in 64 patients (55%), cerebellum in 35 patients (30%), basal ganglia in 20 patients (17%), brainstem in 14 patients (12%), and deep white matter in seven patients (6%). Multiple localization were observed in 69 patients (59%).
The localization of vasculitides was reported in 68 patients. Vasculitides was observed in the basal ganglia in 19 patients (27%), middle cerebral artery (MCA) zone in 14 patients (20%), cerebellum in two patients (2%), posterior cerebral artery (PCA) zone in two patients (2%), brainstem in one patient (1%), basilar artery zone in one (1%). Four patients (5%) demonstrated lacunar while four patients (5%) had venous infarctions.
Meningeal involvement was seen about half of patients (44,6%). Both tuberculomas and vasculitic lesions were generally observed as multiple lesions at multiple sites. Cerebral hemispheres and basal ganglia were the most common localizations for tuberculomas and vasculitides, respectively.
G. Kilicoglu, None
H. Tireli, None
S. Senbayrak, None
U. Savascı, None