Clinical and Radiological Profile of Central Nervous System Tuberculosis: A Prospective Observational Study

Background: Central nervous system tuberculosis (CNS TB) is one of the most severe forms of extrapulmonary tuberculosis and is associated with significant morbidity and mortality, particularly in tuberculosis-endemic countries like India. Early diagnosis is often challenging due to its subacute onset and heterogeneous clinical and radiological features [1, 2]. Objectives: To evaluate the clinical profile, radiological findings, and short-term outcomes of patients diagnosed with CNS tuberculosis. Methods: A prospective observational study was conducted over one year at a tertiary care centre. Fifty-two adult patients diagnosed with CNS tuberculosis were included. Clinical features, cerebrospinal fluid (CSF) analysis, and neuroimaging findings were recorded and analysed. Results: The mean age of patients was 34.5 years with a female predominance (53.85%). Tuberculous meningitis was the most common presentation (46.15%), followed by intracranial tuberculoma (42.3%). MRI brain commonly revealed basal meningeal enhancement, hydrocephalus, infarcts, and ring-enhancing lesions. Conclusion: CNS tuberculosis predominantly affects young adults and presents with a wide clinical and radiological spectrum. Early clinical suspicion supported by timely neuroimaging is essential to reduce neurological sequelae and mortality [3].