Tuberculous granulomas in childhood tuberculous meningitis: Radiological features and course

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dc.contributor.authorRavenscroft A.
dc.contributor.authorSchoeman J.F.
dc.contributor.authorDonald P.R.
dc.date.accessioned2011-05-15T16:02:04Z
dc.date.available2011-05-15T16:02:04Z
dc.date.issued2001
dc.description.abstractThe clinical course and serial cranial computerized tomographic (CT) findings of 202 children with tuberculous meningitis (TBM) admitted to Tygerberg Hospital between 1985 and 1994 were reviewed with regard to the incidence, CT appearance and clinical course of associated intracranial tuberculous granulomas. Thirty-four patients (16.85 per cent) had associated intracranial granulomas. Thirty-eight individual lesions were analysed and classified as meningeal, parenchymal or ependymal according to their central nervous system (CNS) location. Twenty-five patients had round to irregular, brain iso-, hypo- or hyperdense meningeal granulomas with variable degrees of enhancement and peri-lesional hypodensities. Four patients had diffusely enhancing, brain isodense, enplaque-like ependymal granulomas associated with the ventricular ependymal lining. Four patients with miliary tuberculosis and TBM showed multiple small diffusely enhancing, brain iso- or hyperdense parenchymal lesions and associated hypodensities on initial CT. Although granulomas in the meningeal and ependymal group had the propensity to paradoxically enlarge or appear on standard four-drug antituberculosis therapy, the majority resolved uneventfully. Rapid resolution of small parenchymal granulomas associated with miliary tuberculosis occurred in all cases. Most granulomas in this series were co-incidental, asymptomatic CT findings. In rare cases, the development or enlargement of a strategically located granuloma may result in complications.
dc.description.versionArticle
dc.identifier.citationJournal of Tropical Pediatrics
dc.identifier.citation47
dc.identifier.citation1
dc.identifier.issn1426338
dc.identifier.other10.1093/tropej/47.1.5
dc.identifier.urihttp://hdl.handle.net/10019.1/12291
dc.subjectprednisone
dc.subjecttuberculostatic agent
dc.subjectanalysis
dc.subjectarticle
dc.subjectbrain ventricle
dc.subjectcentral nervous system
dc.subjectchild
dc.subjectclinical article
dc.subjectcomputer assisted tomography
dc.subjectcontrolled study
dc.subjectdensity
dc.subjectdisease association
dc.subjectdisease classification
dc.subjectdisease course
dc.subjectependyma
dc.subjectgranuloma
dc.subjecthuman
dc.subjectincidence
dc.subjectmeninx
dc.subjectmiliary tuberculosis
dc.subjectparenchyma
dc.subjectpediatric hospital
dc.subjectradiodiagnosis
dc.subjectsymptom
dc.subjecttuberculous meningitis
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectHumans
dc.subjectIncidence
dc.subjectInfant
dc.subjectProspective Studies
dc.subjectSouth Africa
dc.subjectTomography, X-Ray Computed
dc.subjectTuberculoma
dc.subjectTuberculosis, Meningeal
dc.titleTuberculous granulomas in childhood tuberculous meningitis: Radiological features and course
dc.typeArticle
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