The many faces of intracranial tuberculosis: atypical presentations on MRI—a descriptive observational cohort study

Abstract

Abstract Background Atypical MRI findings of cranial tuberculosis can lead to prolonged delay in diagnosis resulting in high costs to evaluate for alternative diagnoses. The aim of this study was to describe a series of cranial tuberculosis patients with spectrum of MRI features, other than hydrocephalus, parenchymal tuberculomas, and leptomeningeal thickening. The final diagnosis was made based on CSF findings, clinical findings, and/or marked improvement after antitubercular treatment. Results A total of 39 patients met the inclusion criteria and were diagnosed with vasculitis (n = 15), tubercular abscess (n = 5), miliary tuberculosis (n = 3), tubercular cerebritis (n = 9), sellar and parasellar tuberculosis (n = 7), mass forming tuberculosis (n = 1), choroid plexitis (n = 2), and intraventricular tuberculomas (n = 1). Conclusion A significant number of patients of cranial tuberculosis can have variable presentations and may be misdiagnosed. This analysis helps to reinvestigate the spectrum of MRI findings.