Tuberculoma Brain and its Early Radiological Presentation; Descriptive Analytical Study
Keywords:
Tuberculoma, Radiology, Caseation.Abstract
OBJECTIVE: To highlight the radiological presentation of tuberculoma brain in association with clinical
features of the disease
METHODOLOGY: As Descriptive analytical nature of study, it was held in Radiology Department of
liaquat University Hospital Hyderabad from June 2018 to December 2018. The cases were referred from
medicine and neurosurgery ward to the radiology department for MRI and CT scans. The fillings of
questionnaire and co relation of its radiological findings with clinical aspect were examined by
evaluating patients file and diagnosed on clinical suspicion, CSF findings, improvement on empirical
treatment, diagnosis of exclusion and multi discipline discussion.
RESULTS: Total numbers of 20 patients were included, mostly younger age were affected with male
preponderance. Mostly cases were presented with meningitis (80%), seizures (60%) and history of
tuberculosis (60%). On CT and MRI brain scan, the most common findings were multiple lesions (95%)
showed central hyper-intensity on T2 (55%) with meningeal enhancement (80%), fluid- attenuate
inversion recovery (FLAIR) signals (35%) and hypo-intense core with hyper-intense rim (30%) reflecting
the most of cases with early non caseating nature of tuberculoma. Ring like lesions (80%) and irregular
shape (45%) with (25%) target like lesions were found and associated with edema (55%) and
calcifications (10%).
CONCLUSION: The presentation of tuberculoma is no more a rare manifestation of infective CNS
disease. Early identification on scans with characteristics of early non caseating granuloma can help in
prompt diagnosis and treatment which in turn decreased the disabling nature of disease and its
progression.
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