title: Intracranial tuberculomas in patients with tuberculous meningitis: predictors and prognostic significance.
abstract: METHODS
  Intracranial tuberculomas are commonly observed neuroimaging abnormalities in tuberculous meningitis (TBM).
  
  
  OBJECTIVE
  to evaluate the predictors and prognostic significance of tuberculomas in patients with TBM.
  
  
  METHODS
  In a retrospective follow-up study, contrast-enhanced magnetic resonance imaging was performed at study inclusion and after 9 months of follow-up. Univariate analysis and multivariate analysis were used to identify predictive factors for tuberculoma. Prognosis (death and severe disability) was assessed using the modified Rankin scale.
  
  
  RESULTS
  At inclusion, 43 of 110 patients had cerebral tuberculomas. Seven patients developed paradoxical tuberculomas. Predictors of tuberculomas were raised cerebrospinal fluid (CSF) protein (>3 g/l) and meningeal enhancement. Multivariate analysis did not show any significant predictors. During follow-up, the only significant predictor of paradoxical development of tuberculomas was raised CSF protein (>3 g/l). After 9 months of follow-up, 32 patients had died or had severe disability. Survival analysis revealed that patients with tuberculomas and those without tuberculomas had a similar prognosis.
  
  
  CONCLUSIONS
  Tuberculomas occurred in approximately 39% of the patients with TBM. Significant predictors were meningeal enhancement and raised CSF protein. TBM patients with or without tuberculomas had a similar prognosis.
authors.affiliation: Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, Uttar Pradesh, Lucknow, India.
authors.forename: H K
authors.initials: HK
authors.lastname: Anuradha
authors.forename: R K
authors.initials: RK
authors.lastname: Garg
authors.forename: M K
authors.initials: MK
authors.lastname: Sinha
authors.forename: A
authors.initials: A
authors.lastname: Agarwal
authors.forename: R
authors.initials: R
authors.lastname: Verma
authors.forename: M K
authors.initials: MK
authors.lastname: Singh
authors.forename: R
authors.initials: R
authors.lastname: Shukla
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D002555:Cerebrospinal Fluid / Q000382:microbiology; D016009:Chi-Square Distribution; D003287:Contrast Media; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D016862:Tuberculoma, Intracranial / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D014390:Tuberculosis, Meningeal / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D003287:Contrast Media