Mustafa TAŞKESEN, M. Ali TAŞ, Sultan ECER, M. Nuri ÖZBEK, Ahmet YARAMIŞ

Tüberküloz menenjitli çocuklarda kranial tomografi ve kranial magnetik rezonans bulgularının irdelenmesi

Tüberküloz menenjit; erken tedavisi yapılmadığı takdirde %50-70’lere varan mortaliteye sahiptir.Çalışmaya; Dicle Üniversitesi Çocuk Hastalıkları Kliniği’nde 2000-2003 yılları arasında takip edilen 5 ay-15 yaş arası 142 hasta alındı. 91(%64) erkek, 51(%36) kız idi. Kliniğe başvurudan sonraki ilk üç günde kranial tomografi, ilk on gün içinde kranial magnetik rezonans çekilmiştir. Kranial tomografi çekilmiş (134/142) hastalarda en sık % 91.7 hidrosefali, sonra 14 hastada (%10,4) serebral enfarkt ve beyin ödemi, 13 hastada (%9.7) meningeal ve parankimal tutulum, 11 hastada (%8.2) basal sisternada tutulum, sekiz hastada (%5.9) serebral atrofi , yedi hastada (%5.2) tüberkülom ve son olarak da üç (%2.2) hastada sonuç normal bulundu. Kranial magnetik rezonans çekilmiş (33/142) hastalarımızda en sık %75.7 hidrosefali, sonra %48.4 meningeal ve parankimal tutulum, %45.4 basal sisternada tutulum, %30.2 serebral enfarkt, %15.1 tüberkülom ve %6.0 hastada serebral atrofi olduğu görüldü. Klinik ve anormal BOS bulguları ile tüberküloz menenjit düşünülen hastalarda erken tanı ve tedavi için, erken dönemde bir kranial görüntülemenin yararlı olacağını düşünüyoruz.

Anahtar Kelimeler:

Geriyedönük çalışma, Ergen, Çocuk, Çocuk, okul öncesi, Süt çocuğu, Manyetik rezonans görüntüleme, Tomografi, Tüberküloz, meningeal

The evaluation of cranial tomographical and magnetic resonans image findings otomografiain from the children with tuberculous meningitis

Mortality rate in tuberculous meningitis may reach from 50 % to 70 % if not treated at early stages.This study consists of 142 patients admitted Dicle University of Pediatrics clinic and who were examined regularly in the clinic. Of these patients, 91 (64%) were male and 51(36%) female. Patient ages ranged between five months and 15 years old. Cranial tomographies images of patients were obtained within the first three days and cranial magnetic resonance imaging were obtained within the first ten days of admittance.Cranial tomography findings include hydrocephalus in 134 (134/142) patients(91.7%), cerebral infarct and brain edema in 14 patients (10.4%), meningeal and paranchimal involvement in 13 patients (9.7%), basal cisterna involvement in 11 patients(8.2 %), cerebral atrophy in eight patients (5.9 %) and tuberculoma in seven patients (5.2%), Three patients (2.2 %) were to be found normal. Cranial magnetic resonance imaging otomografiained from 33 patients (most common findings) determined hydrocephalus in 75.7 % of the patients. Meningeal and paranchimal involvement in 48.4 %, basal cisterna involvement in 45.4 %, cerebral infarct in 30.2 %, tuberculoma in 15.1 %, cerebral atrophy in 6.0 % percent of the patients were determined respectively. In conclusion, we believe that in the early stage of the disease otomografiaining cranial imaging in suspected tuberculous meningitis with clinical and abnormal cerebrospinal fluid findings for early diagnosis and treatment should be beneficial.

Keywords:

Retrospective Studies, Adolescent, Child, Child, Preschool, Infant, Magnetic Resonance Imaging, Tomography, Tuberculosis, Meningeal,

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