title: [Tuberculosis of the central nervous system. MRI features and clinical course in 12 cases].
abstract: OBJECTIVE
  The aim of this study was to characterize the MR findings of various intracranial lesions in the central nervous system (CNS) tuberculosis.
  
  
  METHODS
  The MRI findings (T1, T2 and T1 sequence after contrast) of 12 proved cases (10 males, 2 females, 24 to 64 years old, average: 35) of CNS tuberculosis were reviewed; 4 patients were seropositive for HIV.
  
  
  RESULTS
  Several types of lesions were identified: tuberculomas called miliary lesions if they were smaller than 2 mm in diameter (7 cases), in 1 case the tuberculoma was revealed by two large lesions and bi-hemispheric localisations, leptomeningitis (5 cases), infarction (4 cases), abscesses (3 cases with solitary lesions in 2/3 cases), hydrocephalus (3 cases), pachymeningitis (2 cases). A tuberculomas-leptomeningitis association was found in 4 patients. The pachymeningitis form had an unusual aspect in one case. Patients with leptomeningitis showed thick meningeal contrast enhancement involving all basal cisterns, expanding to the sylvian fissures level, and causing narrowing of the sylvian arteries. Massive infarctions resulted from arterial englobement or embols. In three out of five patients, leptomeningitis was the initial presentation. In seropositive patients, tuberculosis was severe with high mortality (3/4 patients), and associated with other multiple lesions.
  
  
  CONCLUSIONS
  Central nervous system tuberculosis has different appearances, mostly tuberculomas and leptomeningitis. MR with contrast is necessary for follow-up during treatment.
authors.affiliation: Département de Neuroradiologie, Hôpital Lariboisière, Paris.
authors.forename: M
authors.initials: M
authors.lastname: Boukobza
authors.forename: I
authors.initials: I
authors.lastname: Tamer
authors.forename: J P
authors.initials: JP
authors.lastname: Guichard
authors.forename: L
authors.initials: L
authors.lastname: Brunereau
authors.forename: M
authors.initials: M
authors.lastname: Polivka
authors.forename: F
authors.initials: F
authors.lastname: Leibinger
authors.forename: D
authors.initials: D
authors.lastname: Reizine
authors.forename: J J
authors.initials: JJ
authors.lastname: Merland
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016862:Tuberculoma, Intracranial / Q000473:pathology*