TITLE:
Neurocysticercosis (NCC) vs Central Nervous System (CNS) Tuberculoma in Children—Dilemma over Clinico-Radiological Diagnosis?
AUTHORS:
Bharat-Bhushan Sharma, Shashi Sharma
KEYWORDS:
Neurocysticercosis, Tuberculomas, Seizures, CT, MRI
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.6 No.3,
September
16,
2016
ABSTRACT: Background: Neurocysticercosis (NCC) and central
nervous system (CNS) tuberculomas often overlap in clinical
presentation and imaging. Though the aetio-pathology entirely differs in both
the scenarios but there is great confusion in their clinico-radiological evaluation as the findings and
appearances are similar in many ways. The stress should be laid out over the
salient features of each entity in the background of their presentation. The
study was conducted to highlight the differentiation of the clinico-radiological
findings in both the entities. Material and Methods: Ten patients between 5 - 15 years
(mean age 10.4 years) with complaints of headache and with or without seizures
had undergone MRI alone or with CT examinations. Basic sequences of T1W, T2W, T2W FLAIR
and T1W contrast studies were carried out in all the cases. CT was carried out
in only three cases and contrast was given in two cases. Results: Eight
patients were having ring enhancing lesions in post contrast studies in MRI and
two had only cystic lesions ranging from 1 - 3 cm in diameter. Conclusion: Seven cases having
tuberculomas were confirmed by both the modalities with one case inconclusive. Two
cases were diagnosed as neurocysticercosis as per the results. The reasonable
achievable target was the goal to differentiate between NCC and tuberculomas in the brain and it was achieved. Contrast
MRI and spectroscopy brought out many findings for the distinct features
in many cases.