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Brain tuberculomas, tubercular meningitis, and post-tubercular hydrocephalus in children

Sandip Chatterjee1

  • 1Department of Neurosurgery, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal, India.

Journal of Pediatric Neurosciences
|November 10, 2011
PubMed

Insights

Central nervous system tuberculosis (CNS TB) in children often manifests as meningitis or hydrocephalus, rarely as tuberculomas. While historically seen in developing nations, it now affects HIV-positive migrants globally, primarily treated with chemotherapy.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Neuroscience

Background:

  • Central nervous system tuberculosis (CNS TB) in children typically presents as tubercular meningitis or post-tubercular meningitis hydrocephalus.
  • Space-occupying lesions, known as tuberculomas, are a rarer manifestation of CNS TB in pediatric populations.
  • CNS TB, once confined to developing regions, is increasingly observed in HIV-positive migrant populations in Western countries.

Purpose of the Study:

  • To review the clinical presentations of CNS TB in children.
  • To discuss the changing epidemiology of pediatric CNS TB.
  • To outline current understanding of pathogenesis and treatment strategies.

Main Methods:

  • Literature review of pediatric CNS TB cases.
  • Analysis of epidemiological trends, including migration and HIV status.
  • Summary of established and emerging treatment modalities.

Main Results:

  • Tubercular meningitis and hydrocephalus are the most common CNS TB forms in children.
  • A significant rise in CNS TB cases among HIV-positive migrants in developed nations is noted.
  • Pathogenesis remains incompletely understood, necessitating further research.

Conclusions:

  • Chemotherapy remains the primary treatment for pediatric CNS TB.
  • Neurosurgical intervention is reserved for specific complications like hydrocephalus or large tuberculomas.
  • Increased global migration and HIV prevalence necessitate heightened awareness and diagnostic vigilance for CNS TB in children.

Keywords:
Hydrocephaluspost-tubercular hydrocephalustuberculoma

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