Diagnostic and Therapeutic Challenges in the Surgical Management of CNS Tuberculosis
Journal Title: International Journal of Medical and Health Sciences - Year 2013, Vol 2, Issue 2
Abstract
Background: Tuberculosis of the central nervous system is very common in South East Asia region and particularly in India. Despite of various diagnostic modalities and treatment options the outcome remains poor.Clinicians face many challenges in management of tubercular infections of the brain and spine. Material & Methods: Twenty five patients with CNS tuberculosis who had undergone neurosurgery were included in this study. All the patients were evaluated with CT scan or MRI or both. After neurosurgical interventions a close observation and regular follow up over a period of two years was done to evaluate the radiological and clinical outcome. Results: The commonest presentation of CNS tuberculosis was hydrocephalus followed by Pott's spine. Radiological investigations and close clinical observation guided the timing of the surgical intervention. All patients showed significant clinical and radiological improvements during follow up. Conclusion:Various investigations provide little support for the management of sequelae of post tubercular meningitis and tuberculosis of the spine. Vigilant clinical observations and imaging studies are required in the early follow up period to identify the worsening or new emerging signs. Imaging studies are becoming the major decisive tools for the diagnosis and evaluation of outcome.
Authors and Affiliations
Vinod K. S. Gautam, S. Khurana and Ravinder Singh
Keywords
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