Tuberculous meningitis—a CT study

Abstract

Cases of tuberculous meningitis (60) including both adults and children were studied. Only 3 cases showed a normal scan. Severe hydrocephalus was present in 87.09% of the children and only in 12.09% of the aduts. The incidence of hydrocephalus increased with the duration of the illness and decreased with age. Exudates in the basal cisterns were graded from mild to severe, the latter being seen only in children. Visible infarcts were shown in 28.33% of the cases; 10% showed associated parenchymal tuberculomas. Serial follow-up scans indicate that patients with non-enhancing exudates have a good prognosis when medically treated; in those cases with enhancing exudates the prognosis is poor in spite of medical treatment and surgical shunting; they either succumb to their illness or are left with irreversible sequelae. CT [computed tomography] has proved sensitive in both the diagnosis and prognosis in clinically suspected tuberculous meningitis.