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. 2023 Jul 6;12(13):4533.
doi: 10.3390/jcm12134533.

Intraspinal and Intracranial Neurotuberculosis, Clinical and Imaging Characteristics and Outcomes in Hospitalized Patients: A Cohort Study (2000-2022)

Ana Luisa Corona-Nakamura  1 , Martha Judith Arias-Merino  2 , María Guadalupe Miranda-Novales  3 , David Nava-Jiménez  1 , Juan Antonio Delgado-Vázquez  1 , Rafael Bustos-Mora  1 , Aldo Guadalupe Cisneros-Aréchiga  1 , José Francisco Aguayo-Villaseñor  1 , Martha Rocio Hernández-Preciado  1   4 , Mario Alberto Mireles-Ramírez  1
Affiliations

Intraspinal and Intracranial Neurotuberculosis, Clinical and Imaging Characteristics and Outcomes in Hospitalized Patients: A Cohort Study (2000-2022)

Ana Luisa Corona-Nakamura et al. J Clin Med. .

Abstract

Neurotuberculosis (neuroTB) is a devastating disease, and is difficult to diagnose. The aim of this study was to analyze the clinical and imaging characteristics, and outcomes of a retrospective cohort (2000-2022) of hospitalized patients diagnosed with intraspinal and intracranial neuroTB. This work was designed through clinical, laboratory and imaging findings. Variables included: demographic data, history of tuberculosis, neurological complications, comorbidities and outcomes. Morbi-mortality risk factors were identified by univariate analysis. The cohort included: 103 patients with intraspinal and 82 with intracranial neuroTB. During the study period, in-hospital mortality of 3% for intraspinal and 29.6% for intracranial neuroTB was estimated. Motor deficit was found in all patients with intraspinal neuroTB. Risk factors for the unfavorable outcome of patients with intraspinal neuroTB were: age ≥ 40 years, diabetes mellitus (DM), diagnostic delay, kyphosis and spondylodiscitis ≥ 3 levels of involvement. Among the patients with intracranial neuroTB, 79/82 (96.3%) had meningitis and 22 patients had HIV infection (10 of them died). Risk factors for mortality from intracranial neuroTB were: HIV infection, hydrocephalus, stroke, lymphopenia and disseminated and gastrointestinal TB. Patients with intraspinal neuroTB had a significant number of destroyed vertebrae that determined their neurological deficit status. The mortality burden in intracranial neuroTB was conditioned by HIV infection and renal transplantation patients.

Keywords: clinical characteristics; imaging; intracranial; intraspinal; neurotuberculosis; outcomes.

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Conflict of interest statement

The authors declare no conflict of interest and they have read and agreed to the published version of the manuscript.

Figures

Figure 4
Figure 4
MRI of thoracic spine post-contrast T1-weighted image. (A) Sagittal image, and (B) Axial image, with lytic lesions of the vertebral bodies and appendiceal involvement from T7 to T9, with prevertebral and epidural abscess. A 29-year-old woman, with pulmonary tuberculosis, who had low back pain for 14 months, spinal tissue culture positive for M. tuberculosis. The image shows multilevel tuberculous spondylodiscitis from T5 to T11 with disc-vertebral destruction with epidural abscess with compression of the spinal cord from T7 to T10. (The photo is from our image gallery).
Figure 5
Figure 5
MRI of brain post-contrast T1-weighted image. (A–C) Tuberculoma in the left temporal lobe. (D,E) Tuberculoma in the midbrain. (F–H) Tuberculoma in the frontal lobe. Sixty-four-year-old patient, with previous use of infliximab, with a fever of 6 months of evolution. Clinical improvement at 2 weeks, and imaging improvement at 9 months after starting antituberculous drugs. (The photo is from our image gallery).
Figure 1
Figure 1
Flow diagram of the intracranial and intraspinal neurotuberculosis cohort.
Figure 2
Figure 2
Diagnostic tools in the cohort of patients with intraspinal and intracranial neurotuberculosis. HPE: Histopathological study. AFB: Acid-fast bacilli. PCR: Polymerase chain reaction. Imaging: Magnetic resonance and computed tomography.
Figure 3
Figure 3
Each case of intraspinal and intracranial neurotuberculosis.
See this image and copyright information in PMC

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References

    1. World Health Organization Tuberculosis Profile: WHO Global. 2021. [(accessed on 28 May 2023)]. Available online: https://worldhealthorg.shinyapps.io/tb_profiles/?_inputs_&lan=%22ES%22&e....
    1. CENAPRECE Casos Nuevos de Tuberculosis Todas Formas Estados Unidos Mexicanos 1990–2016. [(accessed on 28 May 2022)]. Available online: http://www.cenaprece.salud.gob.mx/programas/interior/micobacteriosis/des....
    1. Thakur K., Das M., Dooley K.E., Gupta A. The Global Neurological Burden of Tuberculosis. Semin. Neurol. 2018;38:226–237. doi: 10.1055/s-0038-1651500. - DOI - PubMed
    1. Khanna K., Sabharwal S. Spinal tuberculosis: A comprehensive review for the modern spine surgeon. Spine J. 2019;19:1858–1870. doi: 10.1016/j.spinee.2019.05.002. - DOI - PubMed
    1. Wilkinson R.J., Rohlwink U., Misra U.K., van Crevel R., Mai N.T.H., Dooley K.E., Caws M., Figaji A., Savic R., Solomons R., et al. Tuberculous Meningitis International Research Consortium. Tuberculous meningitis. Nat. Rev. Neurol. 2017;13:581–598. doi: 10.1038/nrneurol.2017.120. - DOI - PubMed

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