Features in tubercular meningoencephalitis diagnosis: 18 childhood cases

The aim of this research is to illustrate clinical and instrumental features of central nervoussystem tuberculosis (CNS-TB) in childhood in order to allow prompt diagnosis and adequate patientmanagement. TB remains one of the most important communicable diseases and represents a majorglobal health problem. Although pulmonary TB tends to be the most common form of the disease, thehighest mortality and morbidity occurs with TB of the central nervous system (CNS-TB), whichdevelops in 4% of children with tuberculosis. It has a high fatality rate and causes serious sequelae,especially during childhood. CT and MR imaging studies of 18 patients (11 female, 7 male, mean age45.72 months) were retrospectively reviewed. A basilar enhancement was detected in all the patients.Other findings were hydrocephalus (61%), intracranial tuberculomas (17%) other nodular (11%) andischemic lesions (11%). Edema, either perilesional or diffuse, was found in 7/18 patients. Severeventricular dilatation was observed in 9/18 cases. Two patients with fatal outcome had severehydrocephalus associated with extensive ischemic areas in one case and intraventricular haemorrhagein the other. Cross-sectional imaging, together with clinical data, may provide useful clues for the earlydiagnosis of CNS-TB and help to prevent unnecessary morbidity and mortality.