REVIEW OF THE CLINICAL, COMPUTERIZED TOMOGRAPHY SCAN AND/OR MAGNETIC RESONANCE IMAGING FINDINGS OF INTRACRANIAL TUBERCULOMA IN AN ETHIOPIAN TEACHING HOSPITAL

Authors

  • Getachew Assefa AAU,COHS,SOM,department of Radiology
  • Fathia Omar Department of Radiology
  • Hagos Biluts AAU,COHS,SOM,department of surgery
  • Mersha Abebe AAU,COHS,SOM,department of surgery

Abstract

Abstract

Background: Ethiopia is one of the countries that has high burden of all forms of tuberculosis and there is no published report on computerized tomography  scan and/or magnetic resonance imaging of intracranial tuberculomas.

Objective : to review the  clinical, computerized tomography and/or magnetic resonance imaging features  of intracranial tuberculoma

Methods: A retrospective review of patient’s medical records of patients operated for intracranial mass that had computerized tomography and/or magnetic resonance imaging brain scans and had histopathological diagnoses, at Tikur Anbessa Specialized Hospital between January 2009 and June 2013.

Results: Of 222 operated cases of intracranial mass subjected to histopathological test 29 (14.6%) were found to  have tuberculomas, 28 (14.1%) had caseous necrosis and one was a tuberculous abscess, in 25 cases  imaging was available for review and were included in the study . There were 15 males and 10 females with age range being 2 to 65 years and with the Median age being 13 years. Twenty patients had computerized tomography and five patients had magnetic resonance imaging. Seizure 15/25 (60%) and headache 11/25 (44%) were the commonest presentation. Solitary or confluent large lesions were seen in 12/25 (48%) of patients. 14/25 (56%) of the lesions had their size between 2 cm and 5 cm. Majority of the lesions 15/25 (60%) were in the frontal and parietal lobes. The lesions were isodense on CT in 18/25 (72%) of the pre-contrast studies and 21/25 (84%) showed ring or rim enhancement after intravenous administration of the contrast medium.

Conclusion: Tuberculoma, more frequently, presented with non-specific clinical findings and chronic seizure disorder and comonly occurred in young patients and often seen infratentorialy. It is often complicated with hydrocephalus in the pediatric age group. Computerized tomography scan and/or magnetic resonance imaging features are not different from reports from other countries.

Key Words: Intracranial Tuberculoma, computerized tomography, magnetic resonance imaging, Ethiopia

 

Author Biographies

Getachew Assefa, AAU,COHS,SOM,department of Radiology

COHS, SOM,Department of Radiology,Radiology,Associate Professor

Fathia Omar, Department of Radiology

COHS, SOM,Department of Radiology, Radiology resident

Hagos Biluts, AAU,COHS,SOM,department of surgery

AAU,COHS,SOM,Department of surgery, neurosurgery unit ,Associate professor in Neurosurgeon and G. Surgeon

Mersha Abebe, AAU,COHS,SOM,department of surgery

AAU,COHS,SOM,Department of surgery, neurosurgery unit ,Assistant professor in Neurosurgeon and G. Surgeon

References

References

Chatterjee S: Brain tuberculomas,tubercular meningitis, and post-tuberular hydrocephalus in children. J Pediatric Neurosci. 2010 6 (Sppl 1): S96-S100.

Kent SJ, Crowe SM, Yung A, Lucas CR, Mijch AM. Tuberculous1meningitis: a 30-year review. Clin Infect Dis 1993; 17: 987-94.

Global and national burden of tuberculosis WHO report. 2009.

Bouchama A’, al-kawi MZ, Kanaan I, Coates R, Jallu A, Rahm B, Siquera EB. Brain biopsy in tuberculoma: the risks and benefits. Neurosurgery. 1991 Mar;28(3):405-9.

Rich AR, McCordock HA. The pathogenesis of tuberculous meningitis. Bull Johns Hopkins Hosp. 1933;52:5-37.

Garg RK. Tuberculosis of the central nervous system. Postgrad Med J. 1999;75:133-40

Sultas PN, Unal A, Forta H, Senol S, Kirbas D. Tuberculous meningitis in adults: Review of 61 cases. Infection.2003;31:387-91.

Curless RG, Mitchell CD. Central nervous system tuberculosis in children. Pediatr Neurol 1991; 7:270–74.

Ravindra Kumar Garg. Diagnosis of intracranial Tuberculoma. Ind. J. Tub., 1996; 43: 35

Gupta RK, Jena A, Sharma A, et al. MR imaging of intracranial tuberculomas. J Comput Assist Tomogr1988; 12(2):280–85.

Gupta RK, Lufkin RB. MR imaging and spectroscopy of central nervous system infection. In Tuberculosis and other non-tuberculous bacterial granulomatous infection. Kluwer Academic/Plenum Publishers: New York; 2001. p. 95-145.

Gupta RK, Pandey R, Khan EM, Mittal P, Gujral RB, Chhabra DK. Intracranial tuberculomas: MRI signal intensity correlation with histopathology and localized proton spectroscopy. Magn Reson Imaging 1993; 11:443-9.

Mohammed W., Bhojo A. Kheleani, Mahesh K. Moolani et al: Brain CT and MRI findings in 100 consecutive patients with intracranial tuberculoma. Journal of Neuroimaging. 07, 2003, 13(3):240-47.

Tae Kyoung Kim, Kee Hyun Chang, Chong Jai Kim et al. Intra cranial Tuberculoma: comparison of MR with pathological Findings. AJNR Am J Neuroradiol 16:1903-1908, October 1995.

Benaerts A, Vanhoenaker FM, Parizel PM, Van Goethen JW, Van Altena R, Laridon A, et al. Tubeculosis Of the central nervous system: Overview of neuroradiological findings. Eur Radiol. 2003; 13:1876-90.

Tuberculosis of the central nervous system. Postgrad Med J 1999:75:133-140 doi:10.1136/pgm.75.881.133

Kumar, R.,C.K. Pandey,N. Bose, and S. Sahay. 2002.Tuberculosis brain abscess: clinical presentation , pathophysiology and treatment (in Children). Childs Nerv. Syst. 18:118-23.

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Published

2016-07-01

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Original Article