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La radiologia medica

, Volume 117, Issue 4, pp 669–678 | Cite as

Central nervous system tuberculosis in non-HIV-positive children: a single-center, 6 year experience

  • L. Nogueira DelfinoEmail author
  • G. Fariello
  • L. Lancella
  • C. Marabotto
  • L. Menchini
  • R. Devito
  • Y. Errante
  • C. C. Quattrocchi
  • D. Longo
Paediatric Radiology / Radiologia Pediatrica

Abstract

Purpose

The aim of this paper is to describe the imaging features of central nervous system (CNS) tuberculosis on computed tomography (CT) and magnetic resonance imaging (MRI) studies in non-HIV-positive children.

Materials and methods

A retrospective descriptive evaluation was conducted on imaging studies obtained from ten children admitted to our hospital over a 6-year period who fulfilled criteria for a diagnosis of CNS tuberculosis. Data were collected with regard to patients’ clinical, laboratory and demographic characteristics, as well as results of radiological investigation.

Results

We studied ten children, of whom five were boys and five were girls and whose mean age was 4 (range 7 months to16) years. Neuroradiological findings on the first imaging study were basal meningeal enhancement (100%), hydrocephalus (70%), infarcts (90%), tuberculomas (40%) and cranial nerve involvement (20%). Follow-up studies revealed basal meningeal enhancement, hydrocephalus, and infarcts in all patients, tuberculomas in 70% and cranial nerve involvement in 50%. Only one patient showed a pattern of miliary tuberculosis.

Conclusions

CNS tuberculosis is still an important cause of childhood morbidity and mortality even in nonimmunosuppressed children. Because prompt diagnosis results in earlier treatment, it is crucial to be aware of tuberculous meningitis and its complications at imaging, especially because of the impact on patients’ prognosis.

Keywords

Neurotuberculosis Tuberculous meningitis Hydrocephalus Vasculitis MRI CT 

La tubercolosi del sistema nervoso centrale in bambini non-HIV positivi: l’esperienza di 6 anni di osservazione in un unico centro

Riassunto

Obiettivo

Scopo di questo studio è descrivere le caratteristiche della tubercolosi del sistema nervoso centrale alla tomografia computerizzata e alla risonanza magnetica, in un gruppo di bambini non positivi al virus dell’immunodeficienza umana acquisita (HIV).

Materiali e metodi

Abbiamo condotto una indagine retrospettiva descrittiva su 10 bambini con diagnosi di tubercolosi del sistema nervoso centrale, ricoverati nel nostro ospedale in un periodo di 6 anni. I dati dei pazienti riguardavano gli aspetti clinici, laboratoristici, demografici e neuroradiologici.

Risultati

Sono stati ammessi nello studio 10 pazienti, 5 maschi e 5 femmine. L’età media dei pazienti era di 4 anni (tra 7 mesi e 16 anni). I reperti neuroradiologici rilevati all’indagine iniziale sono stati impregnazione delle meningi della base cranica (100%), idrocefalo (70%), lesioni infartuali (90%), tubercolomi (40%) e interessamento dei nervi cranici (20%). Nel controllo successivo tutti i pazienti presentavano impregnazione delle meningi della base cranica, idrocefalo e infarti, il 70% presentava tubercolomi e il 50% interessamento dei nervi cranici. Solo in un paziente è stata evidenziata una forma miliare.

Conclusioni

La infezione tubercolare del sistema nervoso centrale è ancora un’importante causa di morbilità e mortalità in bambini non immunodepressi. Poiché l’inizio precoce della terapia determina una prognosi migliore è importante effettuare una diagnosi neuroradiologica tempestiva.

Parole chiave

Tubercolosi del sistema nervoso centrale Meningite tubercolare Idrocefalo Vasculite RM TC 

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Copyright information

© Springer-Verlag Italia 2011

Authors and Affiliations

  • L. Nogueira Delfino
    • 1
    Email author
  • G. Fariello
    • 1
  • L. Lancella
    • 2
  • C. Marabotto
    • 2
  • L. Menchini
    • 1
  • R. Devito
    • 3
  • Y. Errante
  • C. C. Quattrocchi
    • 1
  • D. Longo
    • 1
  1. 1.Department of Radiology, IRCCSOspedale Pediatrico Bambino GesùRomeItaly
  2. 2.Departement of Infective Disease, IRCCSOspedale Pediatrico Bambino GesùRomeItaly
  3. 3.Department of Pathology, IRCCSOspedale Pediatrico Bambino GesùRomeItaly

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