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[Cerebral tuberculoma. Report of 8 cases]
J T Martínez Lacasa1, J Burillo, R Niubó
1Servicio de Medicina Interna, Hospital de Bellvitge-Prínceps d'Espanya, Barcelona.
Abstract:
A series of eight patients with cerebral tuberculoma seen between 1980 and 1990 is reported. Headache was the leading clinical finding, followed by focal neurological findings and seizures. Papilledema was the most uniform examination finding associated with intracranial hypertension. Five patients had another localization of tuberculosis: three had tuberculous meningitis, one had tuberculous pericarditis and only one had associated active pulmonary involvement. Cerebrospinal fluid was investigated in seven patients. In three patients data of tuberculous meningitis were found, with positive culture in Löwenstein medium. Two patients had the acquired immunodeficiency syndrome. All patients received medical treatment with good response, except in one who developed paradoxical expansion of the lesions after two months of therapy.
Insights
Cerebral tuberculoma, a serious tuberculosis manifestation, presents with headache, neurological deficits, and papilledema. Medical treatment is effective, though paradoxical lesion expansion can occur.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Context:
- Cerebral tuberculoma is a rare but severe form of extrapulmonary tuberculosis.
- Diagnosis and management can be challenging, especially in patients with co-existing conditions.
Purpose:
- To report a series of eight patients diagnosed with cerebral tuberculoma between 1980 and 1990.
- To analyze the clinical presentation, diagnostic findings, and treatment outcomes.
Summary:
- Headache, focal neurological deficits, and seizures were common clinical findings.
- Papilledema indicated intracranial hypertension. Five patients had disseminated tuberculosis.
- Cerebrospinal fluid analysis supported tuberculous meningitis in three patients. Two patients had acquired immunodeficiency syndrome (AIDS).
Impact:
- All patients responded well to medical treatment, highlighting its efficacy.
- One case demonstrated paradoxical lesion expansion, a known complication of tuberculosis treatment.