Ring enhancing lesions in cect brain in children: a comparative study of ncc and tuberculoma

Author: 
Radha Mohan M., Rajashekar K., Sirisha Pand Kannaiah B

Background: One of the common indications for CT cranium is seizures, especially first episode seizures in children. There are varying reports of prevalence and incidence of various lesions in CT brain. A single ring enhancing lesion is a common finding in patients with seizures1. This article provides a systematic evaluation of the current state of knowledge in this area. Aim: To study the incidence of ring enhancing lesions in Contrast Enhanced Computerized Tomography (CECT) and compare the incidence and clinical manifestations of Neurocysticercosis (NCC) and Tuberculoma, presenting a ring enhancing lesions in CECT brain scan. Materials and Methods: 170 children with seizures and other non seizure CNS manifestations between 2-12 yr of age were included in study. This study was conducted in Department of Pediatrics in a Teaching Hospital in Telangana state, India during July 2017 to September 2019. According to history, clinical examination and investigations patients were divided into 3 groups. They were cases with NCC, Tuberculoma and Undetermined group. Statistical analysis was done once diagnoses were made. Results: 90 cases have been shown ring enhancing lesions out of 170 i.e. incidence is 52.94%. Out of 90 cases, 53 patients (58.9%) were diagnosed as NCC and 13 patients (14.4%) were diagnosed as Tuberculoma. 24 patients (26.7%) were kept in undetermined group. Patients with NCC were presented usually with seizures alone and patients with Tuberculoma were presented with raised ICT and/or focal deficit. Conclusion: Single ring enhancing lesions are the commonest radiological abnormality in children with seizures. The two most common etiologies are neurocysticercosis (NCC) and tuberculoma. The differentiation between these two assumes greater importance because solitary cysticercosis a benign disorder that resolves spontaneously, a tuberculoma requires prolonged therapy with potentially toxic drugs2, 3. Our study shows NCC is more common than tuberculoma.

Page: 
5723-5727
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DOI: 
http://dx.doi.org/10.24327/23956429.ijcmpr2021998
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