Tuberculous meningitis (a clinico-pathological study).

Tuberculosis is a common infectious disease caused by Mycobacterium tuberculosis. One third of world's population is infected with tuberculosis, but only 10% of them will develop the clinical disease (1). Tuberculous Meningitis (TBM) was first described as a distinct pathological entity in 1836 (2). At present, TBM is the fifth most common extrapulmonary tuberculosis in the United States (US) accounting for 5.2% of these cases and 0.7%of all reported cases of tuberculosis (3). Incidence of TBM in Indian patients with tuberculosis was reported to vary from 7 11.8% (4). Risk factors identified for the development of TBM include extremes of age, alcoholism, diabetes, malignancy, recent corticosteroid use and HIV infection (1). Diagnosis of TBM purely on clinical grounds is usually impossible and all available investigations have got their limitations. Many studies reported in literature stress the importance of early diagnosis and prompt institution of antitubercular chemotherapy (1,5-10). So, there is an urgent need of a diagnostic test for TBM that is simple, quick, affordable and widely available. Neuroimaging in the form of CT-scan has got both diagnostic and prognostic significance in case of TBM (11,12). The present study was designed to study CTscan Changes in brain in TBM and to correlate the CTscan changes with the stage and outcome of the disease. Material & Methods The study was conducted at Government Medical College Jammu and its associated hospital, SMGS Hospital Jammu from October 2005 and lasted till September 2006. All patients with a clinical and laboratory diagnosis of tuberculous meningitis and consenting to participate were eligible for the study. Inclusion criteria were i) History of symptoms suggestive of TBM, ii) Clinical signs of meningeal irritation, iii) Fundoscopic findings of papilledema, optic atrophy or choroid tubercles, Introduction Abstract To study the CT-scan changes in brain in patients of tuberculous meningitis and their correlation with stage of disease and its outcome.A prospective, hospital based, clinico radiological study of one year duration including 48 pediatric and 44 adult patients. 50% of patients in the stage I had normal CT-Scan and this proportion decreased to 10.53% in stage II and 6.67% in stage III. A normal CT-scan is associated with complete recovery in 72.22%, partial recovery in 16.67% and death in 11.11% of cases. Abnormal CTscan is associated with advancing stages of disease and a poor outcome. CT-scan is a valuable tool for diagnosis and monitoring the progress of cases of tuberculous meningitis.