Learning objectives
To analyze central nervous system (CNS) tuberculosis manifestations’ spectrum by topography.
To outline the most useful imaging characteristics fordifferential diagnosis.
Background
Portugal has an approximate tuberculosis prevalence of 20 cases per 100 000 individuals,
being one of the countries with the highest TB burden in the European Union,
and the highest between Western Europe countries.
On the other hand,
the health political agreements between Portugal and Portuguese speaking African countries for the evacuation of patients contributes to further increase ourcontact with the disease.
Tuberculosis is caused by bacteria of the Mycobacterium tuberculosis complex,
although most tuberculous infections of the CNS arecaused by M.
tuberculosis.
It usually...
Findings and procedure details
Central nervous system tuberculosis has a broad imaging spectrum,
including meningitis,
intracranial tuberculous granuloma (tuberculoma),
abscess,
cerebritis and miliary tuberculosis.
Spinal tuberculosis includes spinal cord meningitis,
epidural or subdural abscess and tuberculoma.
Complications include hydrocephalus,
ventriculitis,
vasculitis and ischemic infarcts.
The major CNS TB imaging findings will be revised in this work.
BRAIN
Meningitis
Meningitis is the most common manifestation of CNS tuberculosis and is most common in children and adolescents.
Clinically,
it has an insidious course with a nonspecific clinical presentation with fatigue,
anorexia,...
Conclusion
There is a wide tuberculosis CNS involvement.
The single most important determinant of outcome is the stage at which treatment has been started,
therefore it is crucialto ease differential diagnosis and to raise awareness for this aetiology.
Personal information
Catarina Perry da Câmara,
Neuroradiology Department,
Centro Hospitalar Universitário Lisboa Central,
Portugal
[email protected]
References
1.Rock RB,
Olin M,
Baker CA,
Molitor TW,
Peterson PK.
Central nervous system tuberculosis: pathogenesis and clinical aspects.Clin Microbiol Rev.
2008;21(2):243-61,
table of contents.
2.
Burrill J.,
Williams C.,
Bain G.,
Conder G.,
Hine A.L.,
Misra R.
R.
Tuberculosis: a radiologic review.
Radiographics.
2007;27(5):1255-1273.
doi: 10.1148/rg.275065176.
3.
Engin G,
Acunas B,
Acunas G,
Tunaci M.
Imaging of extrapulmonary tuberculosis.Radiographics.
2000 Mar-Apr; 20(2):471-88; quiz 529-30,
532.
4.Sanei Taheri M,
Karimi MA,
Haghighatkhah H,
Pourghorban R,
Samadian M,
Delavar Kasmaei H.
Central nervous system tuberculosis: an imaging-focused...
