Tuberculosis neurochiasmal: imaging findings. Experience National Institute of Neurology and Neurosurgery 2008-2014

Abstract

Tuberculosis (TB) is caused by Mycobacterium tuberculosis, affects nine million people worldwide. The neurochiasmal TB can occur as a manifestation of extrapulmonary primary infection and can have their lung origin in the central nervous system or elsewhere in the body. The involvement may be unilateral or bilateral, can manifest as an inflammation of the optic nerve (ON), perineuritis (inflammation of the sheath NO), arachnoiditis meningeal infiltration or nerve compression caused by a tuberculoma. Most patients may have concomitant TB meningitis. Objective: to know the neuro-ophthalmology MRI of TB at the Institute demonstrations. Methods: we included 24 patients (16 men and 8 women), of whom 16 had histopathological diagnosis and PCR (polymerase chain reaction). These patients were sent to the department of neuroimaging in April 2008 to June 2014. Results: 24 patients were evaluated with neuro-ophthalmological manifestations of cavernous sinus syndrome, orbital apex syndrome, chiasm or optic neuritis and histopathological diagnosis or paraclinical (immunoassay) positive for tuberculosis. Sixteen positive patients were diagnosed with immunoassay (CSF PCR for M. TB) and diagnostic histopathological (66.6%). Six patients had only histopathological diagnosis (25%), a positive TB patient (4.1%) and one had a positive response to TB treatment (4.1%). Conclusion: the disease had imaging condition typically bilateral. The main symptom was decreased visual acuity and headache presented in 50% of cases.