Prospective Study of Intracranial Space Occupying Lesions in Children in Correlation with C.T. Scan

AIMS AND OBJECTIVES OF THE STUDY- Intracranial space occupying lesions are not uncommon in children. Withoutearly diagnosis and treatment, they cause great mortality and morbidity. Intracranialspace occupying lesions in children are recognized much earlier now in thecourse ofthe disease than theywere two decades ago, partly as a result of improveddiagnostic neuroradiology. Furthermore the outlook for children with intracraniallesions is more hopeful because ofthe improvement ofsurgical techniques and othertherapeutic modalities. Taking the above points into the consideration, this study is under taken to Analyses the age and sex incidence, clinical features, etiology of ICSOL in children. The advantage of CT scan in making early and specific diagnosis of ICSOL especially granulomatous lesions were also studied. Materials and methodsPatients presenting with signs and symptoms of ICSOL in pediatric outpatient and inpatient departments in Government General Hospital& MRI over 2year period who showed evidence of ICSOL on CT scan were taken up for study. Thepatient is investigated on routine and specific lines to find out possible etiologicalagent like infective, parasitic, vascular, developmental, neoplastic or otherwise. All patients who showed signs and symptoms of raised intracranial tensionwere subjected to CT Scanning of brain (Plain / with contrast) done in all patients enrolled in the study. For the diagnosis of tuberculoma. Clinical data. Nutritional and immunization status, history of contact with tuberculosis patient in the family. Extra cranialevidence of tuberculous infection, positive tuberculin or BCG test. Radiologicalevidence of intrathoracic tuberculosis, microscopic examination of sputum andgastric aspirate, tuberculous histology of the lymphnode and CT Characteristics ofthe lesion were taken into consideration. Small enhancing lesions on Computerized Tomography (CT) is a commonfinding in patients with signs and symptoms of ICSOL. Cysticercus granulomasand tuberculomas are the two common conditions to be considered for the diagnosis, Many of non invasive tests fail to differentiate between these two pathologies. Asboth ofthese lesions can be managed conservatively, it would be ideal if an etiological diagnosis could be made without a biopsy. The specific serological tests are also not availablein this institution for diagnosing above conditions. As such the diagnosis in the present study is mainly based on clinical and CT Scan criteria as the study conducted by Dr. V. Rajshekhar et al 12, Differentiating small cysticercus granulomas and tuberculomas in patients with epilepsy.