Article Text

PDF
Clinicoradiological features of tuberculous meningitis in patients over 50 years of age
  1. S G Srikanth1,
  2. A B Taly2,
  3. K Nagarajan1,
  4. P N Jayakumar1,
  5. S Patil3
  1. 1Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India
  2. 2Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India
  3. 3Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences, Bangalore, India
  1. Correspondence to:
 Dr S G Srikanth
 Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore 560029, India; sgsrikanth{at}yahoo.com

Abstract

Background and aim: Tuberculous meningitis (TBM) is a debilitating form of CNS tuberculosis with a high morbidity and mortality in spite of treatment. The diagnosis is based on clinical, radiological and laboratory features. The classical CT features of basal exudates, hydrocephalus, infarcts and granulomas have been mostly reported in younger individuals. Our aim was to study imaging features of TB meningitis in adults over the age of 50 years.

Materials and methods: Clinical, imaging and laboratory features of 53 adult patients over the age of 50 years (sixth to eighth decades) were studied retrospectively. Diagnosis of TBM was based on clinical and laboratory features.

Results: Imaging features were the conspicuous absence of typical features of TBM (ie, basal meningeal enhancement, hydrocephalus, infarcts/granulomas were seen in only a minority of patients).

Conclusions: CT features of TBM in elderly patients were few, atypical and non-contributory for diagnosis, probably because of age related immune senescence. Strong clinical suspicion and correlation with laboratory findings is necessary for early diagnosis.

  • TBM, tuberculous meningitis

Statistics from Altmetric.com

Footnotes

  • Published Online First 12 January 2006

  • Competing interests: None declared.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.