Intracranial tuberculoma and recent advances in magnetic resonance imaging

Abstract

Background Tuberculosis is resurging both in the developing and developed worlds. This includes TB of the central nervous system which is more common in children. It carries a high mortality rate and can lead to significant levels of neurological morbidity. Magnetic resonance imaging offers the potential to diagnose intracranial tuberculoma and to differentiate it from other single hyper dense intracranial lesions. Methods The authors report thirteen patients who proved to have intracranial tuberculoma with emphasis on their magnetic resonance imaging. They all presented with varying degrees of raised intracranial pressure. All the thirteen patients had a CT scan which showed a single hyper dense lesion. After contrast the density of the lesions increased. To confirm the diagnosis of intracranial tuberculomas and to differentiate it from intracranial single hyper dense lesions, conventional pre and post contrast MRI imagining followed by FLAIR sequences and diffusion-weighted echo-planner imagining (EPI) was carried out. Results All our patients were treated by corticosteroids for eight weeks and anti-tuberculous medication for a minimum period of twelve months. The treatment was successful in all our patients and none required surgery. Conclusions Early and clear diagnosis of intracranial tuberculoma can be achieved by MRI imaging including flair sequences and diffusion-weighted Echo-planner imaging, (EPI). This leads to early treatment and better outcomes of tuberculosis of the central nervous system.