Radiologic and Clinical Findings in Tuberculous Meningitis

We aimed to evaluate the radiologic and clinical findings of patients with tuberculous meningitis encountered during a 4-year period, retrospectively. Sixteen patients with tuberculous meningitis were admitted to our hospital. The diagnosis was based on abnormal neurologic symptoms and signs, cerebrospinal fluid findings, negative bacteria culture, and abnormalities on brain-imaging studies. CT and MR examinations were performed in 16 and 9 patients, respectively. A retrospective comparison was done between CT and MR findings. All patients had fever, lethargy, and some of them had cough. Neurologic presentations included increased intracranial pressure, vomiting, seizures, paresis, nuchal rigidity, and disturbance of consciousness. Acid-fast stain of cerebrospinal fluid for tuberculous bacilli was negative for all samples. All bacterial cultures of cerebrospinal fluid yielded no growth, with the exception of one that grew Mycobacterium tuberculosis. Radiologic findings compatible with tuberculous meningitis including hydrocephalus, basilar cistern enhancement and infarction was observed more clearly on MR than CT. Early diagnosis in tuberculous meningitis may prevent neurologic damage. Imaging studies is an important part of diagnosis and MR imaging should be performed as a first choice of imaging modalities in patients with tuberculous meningitis.