SETTING: Intracranial tuberculomas are commonly observed neuroimaging abnormalities in tuberculous meningitis (TBM). OBJECTIVE: to evaluate the predictors and prognostic significance of tuberculomas in patients with TBM. DESIGN: In a retrospective follow-up study, contrast-enhanced magnetic resonance imaging was performed at study inclusion and after 9 months of follow-up. Univariate analysis and multivariate analysis were used to identify predictive factors for tuberculoma. Prognosis (death and severe disability) was assessed using the modified Rankin scale. RESULTS: At inclusion, 43 of 110 patients had cerebral tuberculomas. Seven patients developed paradoxical tuberculomas. Predictors of tuberculomas were raised cerebrospinal fluid (CSF) protein (>3 g/l) and meningeal enhancement. Multivariate analysis did not show any significant predictors. During follow-up, the only significant predictor of paradoxical development of tuberculomas was raised CSF protein (>3 g/l). After 9 months of follow-up, 32 patients had died or had severe disability. Survival analysis revealed that patients with tuberculomas and those without tuberculomas had a similar prognosis. CONCLUSION: Tuberculomas occurred in approximately 39% of the patients with TBM. Significant predictors were meningeal enhancement and raised CSF protein. TBM patients with or without tuberculomas had a similar prognosis.
SETTING:Intracranial tuberculomas are commonly observed neuroimaging abnormalities in tuberculous meningitis (TBM). OBJECTIVE: to evaluate the predictors and prognostic significance of tuberculomas in patients with TBM. DESIGN: In a retrospective follow-up study, contrast-enhanced magnetic resonance imaging was performed at study inclusion and after 9 months of follow-up. Univariate analysis and multivariate analysis were used to identify predictive factors for tuberculoma. Prognosis (death and severe disability) was assessed using the modified Rankin scale. RESULTS: At inclusion, 43 of 110 patients had cerebral tuberculomas. Seven patients developed paradoxical tuberculomas. Predictors of tuberculomas were raised cerebrospinal fluid (CSF) protein (>3 g/l) and meningeal enhancement. Multivariate analysis did not show any significant predictors. During follow-up, the only significant predictor of paradoxical development of tuberculomas was raised CSF protein (>3 g/l). After 9 months of follow-up, 32 patients had died or had severe disability. Survival analysis revealed that patients with tuberculomas and those without tuberculomas had a similar prognosis. CONCLUSION:Tuberculomas occurred in approximately 39% of the patients with TBM. Significant predictors were meningeal enhancement and raised CSF protein. TBM patients with or without tuberculomas had a similar prognosis.
Authors: Griselda Escobedo-Meléndez; Leopoldo Portillo-Gómez; Miguel A Andrade-Ramos; David Bocanegra; Rodrigo Mercado-Pimentel; Luis Arredondo; Dara Torres; Miguela A Caniza Journal: BMC Res Notes Date: 2014-12-16
Authors: D A Barr; A K Coussens; S Irvine; N D Ritchie; K Herbert; B Choo-Kang; D Raeside; D J Bell; R A Seaton Journal: Int J Tuberc Lung Dis Date: 2017-06-01 Impact factor: 2.373