Tuberculous meningitis--a CT study

This study comprises 60 cases of tuberculous meningitis including both adults and children. Only three cases showed a normal scan. Severe hydrocephalus was present in 87.09% children and only 12.09% adults. The incidence of hydrocephalus increased with the duration of the illness and decreased with age. Exudates in the basal cisterns were graded from mild to severe, the latter being seen only in children. Visible infarcts were shown in 28.33% of cases, 10% showed associated parenchymal tuberculomas. Serial follow-up scans indicate that patients with non-enhancing exudates have a good prognosis when medically treated, whereas in those cases with enhancing exudates the prognosis is poor in spite of medical treatment and surgical shunting; they either succumb to their illness or are left with irreversible sequelae. CT has proved sensitive in both the diagnosis and prognosis in clinically suspected tuberculous meningitis.