Distribution of brain infarction in children with tuberculous meningitis and correlation with outcome score at 6 months
Date
2006
Authors
Andronikou S.
Wilmshurst J.
Hatherill M.
VanToorn R.
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Abstract
Background: Prognostic indicators for tuberculous meningitis (TBM) offer realistic expectations for parents of affected children. Infarctions affecting the basal ganglia are associated with a poor outcome. Objective: To correlate the distribution of infarction in children with TBM on CT with an outcome score (OS). Materials and methods: CT brain scans in children with TBM were retrospectively reviewed and the distribution of infarctions recorded. The degree of correlation with OS at 6 months was determined. Results: There was a statistically significant association between all sites of infarction (P=0.0001-0.001), other than hemispheric (P=0.35), and outcome score. There was also a statistically significant association between all types of infarction (P=0.0001-0.02), other than hemispheric (P=0.05), and overall poor outcome. The odds ratio for poor outcome with bilateral basal ganglia and internal capsule infarction was 12. The odds ratio for poor outcome with 'any infarction' was 4.91 (CI 2.24-10.74), with 'bilateral infarctions' 8.50 (CI 2.49-28.59), with basal ganglia infarction 5.73 (CI 2.60-12.64), and for hemispheric infarction 2.30 (CI 1.00-5.28). Conclusion: Infarction is associated with a poor outcome unless purely hemispheric. MRI diffusion-weighted imaging was not part of this study, but is likely to play a central role in detecting infarctions not demonstrated by CT. © Springer-Verlag 2006.
Description
Keywords
adolescent, article, basal ganglion, brain infarction, capsula interna, child, computer assisted tomography, correlation analysis, diagnostic accuracy, diagnostic value, diffusion weighted imaging, disease association, female, human, image analysis, infant, major clinical study, male, medical record review, nuclear magnetic resonance imaging, outcomes research, priority journal, prognosis, scoring system, statistical significance, tuberculous meningitis, Adolescent, Brain, Brain Infarction, Child, Child, Preschool, Female, Humans, Infant, Male, Odds Ratio, Prognosis, Retrospective Studies, Tomography, X-Ray Computed, Tuberculosis, Meningeal
Citation
Pediatric Radiology
36
12
36
12