Type:
Educational Exhibit
Keywords:
CNS, Neuroradiology brain, Neuroradiology spine, MR, MR-Diffusion/Perfusion, Imaging sequences, Complications, Infection, Abscess, AIDS
Authors:
C. T. F. Perry da Câmara1, C. Pinheiro2, M. Veiga3, C. Conceição4; 1Lisboa/PT, 2Lisbon/PT, 3Lisboa, Portugal/PT, 4Lisboa /PT
DOI:
10.26044/ecr2019/C-3530
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 our contact with the disease.
Tuberculosis is caused by bacteria of the Mycobacterium tuberculosis complex,
although most tuberculous infections of the CNS are caused by M.
tuberculosis.
It usually spreads haematogenously from the lungs or gastrointestinal tract,
through small subpial or subependymal infective foci (Rich foci),
which can remain dormant for many years.
Their location and the capacity to control them ultimately determine which form of CNS tuberculosis occurs. These foci can,
for example,
later increase in size and rupture into the subarachnoid space,
originating TB meningitis.
CNS involvement occurs approximately in 2-5% of patients with tuberculosis (about 1% has spine involvement),
up to 15% in those with AIDS.
In this subgroup clinical manifestations,
management and epidemiology may vary.