Single photon emission computed tomography in tuberculous meningitis

Citation
Uk. Misra et al., Single photon emission computed tomography in tuberculous meningitis, POSTG MED J, 76(900), 2000, pp. 642-645
Citations number
17
Language
INGLESE
art.tipo
Article
Categorie Soggetti
General & Internal Medicine
Journal title
POSTGRADUATE MEDICAL JOURNAL
ISSN journal
0032-5473 → ACNP
Volume
76
Issue
900
Year of publication
2000
Pages
642 - 645
Database
ISI
SICI code
0032-5473(200010)76:900<642:SPECTI>2.0.ZU;2-E
Abstract
Introduction-Data on single photon emission computed tomography (SPECT) in tuberculous meningitis are lacking and prompted this study. SPECT findings in tuberculous meningitis are reported and correlated with clinical and rad iological findings. Patients and methods-Seventeen patients with tuberculous meningitis that wa s diagnosed on clinical, radiological, and laboratory criteria have been in cluded. Their age ranged between 5 and 62 years and four of them were femal e. Computed tomography and/or magnetic resonance imaging (MRI) and SPECT us ing Tc-99m-ethylene cystine dimer were performed in all the patients. On th e basis of Barthel index (BI) score the patients' outcome was defined as co mplete (BI = 20), partial (BI = 19-12), and poor recovery (BI<12). Result-Eleven patients were in stage III and three each in stage II and sta ge I tuberculous meningitis. Two patients had hemiplegia and five quadriple gia. Computed tomography was abnormal in 11 out of 16 patients and revealed hydrocephalus in nine, basal exudates, infarction in subcortical white mat ter and basal ganglia in six patients each, frontal cortical infarction in one, and granulomata in three patients. Cranial MRI was carried out in four patients and revealed multiple granulomata, hydrocephalus, and brainstem i nfarction in two patients each. SPECT studies were abnormal in all except t wo patients and revealed hypoperfusion of the basal ganglia in 14, cortical hypoperfusion in 10, and midbrain hypoperfusion in one patient. At the thr ee month follow up four patients had died, five had poor, three partial, an d five complete recovery. The SPECT studies were more frequently abnormal c ompared with computed tomography but did not correlate with stage of mening itis or outcome. Conclusion-In tuberculous meningitis subcortical and cortical hypoperfusion is common but it does not correlate with stage of meningitis or three mont h outcome.