Abstract

Introduction: TB meningitis is a debilitating form of CNS tuberculosis with 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 TBM in adults above the age of 50 years.

Materials & methods: We retrospectively studied clinical, imaging and laboratory features of fifty-three adult patients above the age of fifty years (sixth to eighth decade). Diagnosis of TBM was based on both clinical and laboratory features.

Results: Imaging features were conspicuous absence of typical features of TBM i.e. basal meningeal enhancement, hydrocephalus, infarcts/ granulomas which were seen only in a minority of patients.

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