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Tuberculosis, Brain
Sheri L. Harder, MD, FRCPC
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Tuberculosis (TB)
              • Definitions

                • Infection by acid-fast bacillus Mycobacterium tuberculosis
                • CNS TB almost always secondary to hematogenous spread (often pulmonary)
                  • Manifestations include tuberculous meningitis (TBM)
                  • Localized parenchymal infection (tuberculoma) (common); TB abscess (rare)

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Angiographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. DeLance AR et al: Tuberculoma of the central nervous system. J Clin Neurosci. 20(10):1333-41, 2013
                                            2. Ducomble T et al: The burden of extrapulmonary and meningitis tuberculosis: an investigation of national surveillance data, Germany, 2002 to 2009. Euro Surveill. 18(12), 2013
                                            3. Maclean KA et al: Extrapulmonary tuberculosis: imaging features beyond the chest. Can Assoc Radiol J. 64(4):319-24, 2013
                                            4. Rallis D et al: Current epidemiology of childhood tuberculous meningitis in Greece: a 10-year population-based study. Int J Tuberc Lung Dis. 17(6):847-8, 2013
                                            5. Ramzan A et al: Childhood tubercular meningitis: an institutional experience and analysis of predictors of outcome. Pediatr Neurol. 48(1):30-5, 2013
                                            6. Sher K et al: Stages of tuberculous meningitis: a clinicoradiologic analysis. J Coll Physicians Surg Pak. 23(6):405-8, 2013
                                            7. Sáenz B et al: The dual face of central nervous system tuberculosis: a new Janus Bifrons? Tuberculosis (Edinb). 93(2):130-5, 2013
                                            8. Thwaites GE et al: Tuberculous meningitis: more questions, still too few answers. Lancet Neurol. 12(10):999-1010, 2013
                                            9. van der Plas H et al: Complications of antiretroviral therapy initiation in hospitalised patients with HIV-associated tuberculosis. PLoS One. 8(2):e54145, 2013
                                            10. Patkar D et al: Central nervous system tuberculosis: pathophysiology and imaging findings. Neuroimaging Clin N Am. 22(4):677-705, 2012
                                            11. Wu XR et al: Pediatric tuberculosis at Beijing Children's Hospital: 2002-2010. Pediatrics. 130(6):e1433-40, 2012
                                            12. Be NA et al: Pathogenesis of central nervous system tuberculosis. Curr Mol Med. 9(2):94-9, 2009
                                            13. Centers for Disease Control and Prevention (CDC): Investigation of a genotype cluster of tuberculosis cases--Detroit, Michigan, 2004-2007. MMWR Morb Mortal Wkly Rep. 58(9):226-9, 2009
                                            14. van Well GT et al: Twenty years of pediatric tuberculous meningitis: a retrospective cohort study in the western cape of South Africa. Pediatrics. 123(1):e1-8, 2009
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Tuberculosis (TB)
                                                        • Definitions

                                                          • Infection by acid-fast bacillus Mycobacterium tuberculosis
                                                          • CNS TB almost always secondary to hematogenous spread (often pulmonary)
                                                            • Manifestations include tuberculous meningitis (TBM)
                                                            • Localized parenchymal infection (tuberculoma) (common); TB abscess (rare)

                                                        IMAGING

                                                        • General Features

                                                          • CT Findings

                                                            • MR Findings

                                                              • Angiographic Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. DeLance AR et al: Tuberculoma of the central nervous system. J Clin Neurosci. 20(10):1333-41, 2013
                                                                                      2. Ducomble T et al: The burden of extrapulmonary and meningitis tuberculosis: an investigation of national surveillance data, Germany, 2002 to 2009. Euro Surveill. 18(12), 2013
                                                                                      3. Maclean KA et al: Extrapulmonary tuberculosis: imaging features beyond the chest. Can Assoc Radiol J. 64(4):319-24, 2013
                                                                                      4. Rallis D et al: Current epidemiology of childhood tuberculous meningitis in Greece: a 10-year population-based study. Int J Tuberc Lung Dis. 17(6):847-8, 2013
                                                                                      5. Ramzan A et al: Childhood tubercular meningitis: an institutional experience and analysis of predictors of outcome. Pediatr Neurol. 48(1):30-5, 2013
                                                                                      6. Sher K et al: Stages of tuberculous meningitis: a clinicoradiologic analysis. J Coll Physicians Surg Pak. 23(6):405-8, 2013
                                                                                      7. Sáenz B et al: The dual face of central nervous system tuberculosis: a new Janus Bifrons? Tuberculosis (Edinb). 93(2):130-5, 2013
                                                                                      8. Thwaites GE et al: Tuberculous meningitis: more questions, still too few answers. Lancet Neurol. 12(10):999-1010, 2013
                                                                                      9. van der Plas H et al: Complications of antiretroviral therapy initiation in hospitalised patients with HIV-associated tuberculosis. PLoS One. 8(2):e54145, 2013
                                                                                      10. Patkar D et al: Central nervous system tuberculosis: pathophysiology and imaging findings. Neuroimaging Clin N Am. 22(4):677-705, 2012
                                                                                      11. Wu XR et al: Pediatric tuberculosis at Beijing Children's Hospital: 2002-2010. Pediatrics. 130(6):e1433-40, 2012
                                                                                      12. Be NA et al: Pathogenesis of central nervous system tuberculosis. Curr Mol Med. 9(2):94-9, 2009
                                                                                      13. Centers for Disease Control and Prevention (CDC): Investigation of a genotype cluster of tuberculosis cases--Detroit, Michigan, 2004-2007. MMWR Morb Mortal Wkly Rep. 58(9):226-9, 2009
                                                                                      14. van Well GT et al: Twenty years of pediatric tuberculous meningitis: a retrospective cohort study in the western cape of South Africa. Pediatrics. 123(1):e1-8, 2009