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Cranial epidural tuberculoma. A case report.

C Jacques¹, M Boukobza, M Polivka

¹Department of Neuroradiology and Therapeutic Angiography, Hôpital Lariboisière, Paris, France.

Acta Radiologica (Stockholm, Sweden : 1987)

|August 11, 2000

Summary

A rare cranial epidural tuberculoma was diagnosed in a patient without prior tuberculosis history. Surgical removal and combination therapy led to complete regression of this Mycobacterium tuberculosis infection.

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Area of Science:

Neurology
Infectious Diseases
Radiology

Background:

Cranial epidural tuberculoma is an uncommon manifestation of tuberculosis.
Tuberculous infections of the central nervous system require prompt diagnosis and treatment.

Observation:

A 33-year-old patient presented with a cranial epidural lesion despite no history of tuberculosis.
CT and MR imaging revealed a lesion with epidural extension, bone destruction, intense contrast enhancement, and a necrotic core.
Associated findings included osteitis and a subgaleal abscess.

Findings:

Histology and Mycobacterium tuberculosis identification confirmed the diagnosis of cranial epidural tuberculoma.
Surgical excision of the tuberculoma followed by combination therapy resulted in complete resolution of imaging abnormalities.

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Implications:

This case highlights the importance of considering tuberculosis in the differential diagnosis of cranial epidural lesions, even in patients without a known history.
Accurate radiological assessment and histological confirmation are crucial for effective management.
Successful treatment involves both surgical intervention and appropriate anti-tuberculous chemotherapy.