Background:

Tuberculosis (TB) is the second most common cause of infectious disease and children are most vulnerable. Neuroimaging is an important initial investigation in tubercular meningitis.

Objective: This study was done to describe the association between neuroimaging changes and clinical outcome in children with TBM.

Methodology: This was a cross sectional study on  children with TBM,  between January 2012 and December 2017. TBM was diagnosed on the basis of clinical criteria, cerebrospinal fluid analysis and a response to antituberculous treatment.  Preferably MRI with contrast was done.

Result: Out of 79 pediatric patients 17 patients lost in follow up,  thus total 62 patients were studied. Age at the presentation was in 7 + SD 3.9 year , 51.6%  patients were male .  Rural children were more affected (p= 0.002).  Twenty eight (45.2 %) patients had contact with a person with tuberculosis. Only 3 (4.8%) patients presented within 10 days of duration of illness. Most of the cases (67.7%) were in stage 2 at the time of diagnosis.  Most common clinical feature was fever, seizure and signs of meningeal irritation (all present in 12.9%). In neuroimaging most common findings were tuberculoma (31%), hydrocephalus (29%), and basal meningeal enhancement in 16% children. Regarding outcome,   8 (12.9%) patients expired and 43 patients had sequlae . Commonest complications were epilepsy (27.4%). In patients who died most common neuroimaging finding was hydrocephalus .

Conclusion: The neuroimaging finding is an important predictor of outcome of children with TBM.