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Intracranial tuberculoma. Evaluation and treatment
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi.
Clinical Pediatrics
|October 1, 1988
Summary
Computerized tomography (CT) identified intracranial tuberculoma in 24% of patients with partial seizures and specific symptoms. Medical management of tuberculoma proved effective, with CT lesions regressing within 12 weeks.
Area of Science:
- Neurology
- Radiology
- Infectious Diseases
Background:
- Partial seizures can be associated with serious underlying conditions.
- Tuberculosis can manifest neurologically, including as intracranial tuberculoma.
- Accurate diagnosis of intracranial lesions is crucial for effective treatment.
Purpose of the Study:
- To evaluate the utility of computerized tomography (CT) in diagnosing intracranial tuberculoma in patients with partial seizures.
- To describe the CT imaging characteristics of intracranial tuberculoma.
- To assess the clinical outcome and radiological response to antitubercular therapy.
Main Methods:
- Retrospective review of 83 patients with partial seizures undergoing CT.
- Patients selected based on increased intracranial pressure, systemic tuberculosis, or focal neurological deficit.
- Analysis of CT findings, including lesion morphology and presence of edema.
Main Results:
- Intracranial tuberculoma was diagnosed in 20 (24%) of the screened patients.
- Twelve of 55 patients with tuberculous meningitis also had associated tuberculoma.
- CT findings included ring lesions, discs, and irregular coalescing masses, often with perilesional edema.
Conclusions:
- CT is a valuable tool for diagnosing intracranial tuberculoma in at-risk patients.
- Antitubercular therapy leads to satisfactory clinical outcomes and lesion regression.
- Medical management should be the primary treatment for intracranial tuberculoma, reserving surgery for refractory cases.