Pattern of Intracranial Tuberculomas in Kuwait: A Computed Tomographic Study

Abstract

Objective: To study the spectrum of computed tomographic (CT) morphologies of intracranial tuberculomas and to show the role of CT in evaluating the response to medical management. Subjects and Methods: The case files and CT scans of 20 patients with proven intracranial tuberculomas over a period of 15 years (1985–1999) were reviewed retrospectively. All the patients had pre- and post-contrast axial CT scans of the brain. Follow-up CT studies were done 2–12 months after starting antituberculous chemotherapy (ATT). Results: There were 15 males and 5 females. Single lesions were seen in 65% of patients. The majority of the lesions (78%) were in the frontal and parietal lobes. Rare sites of presentation included midbrain and basal ganglia. The lesions were isodense in 81% of the precontrast studies and all were enhanced after intravenous administration of the contrast medium. Severe mass effect, hydrocephalus and meningeal enhancement were not common findings. In 80% of the patients the follow-up CT scans showed evidence of response to ATT. Conclusion: CT is a reliable modality in the diagnostic workup and follow-up of patients with intracranial tuberculomas. Administration of contrast medium is mandatory for the evaluation of such patients.