[Multiple cerebral tuberculomata involving brainstem and cerebellum--report of a case (author's transl)]

A case of multiple cerebral tuberculomata involving the pons and cerebellum was presented. The lesions were demonstrated by CT as isodense to slightly dense foci. All four intra-axial lesions showed homogeneous enhancement following an intravenous injection of the contrast medium, and one of them was surrounded by a small area of low density, probably representing the perifocal edema. The patient responded well to chemotherapy with streptomycin, hydrazid and rifampicin : cranial nerve signs and long tract signs clearing rapidly and the enhancing lesions and mass effect on CT disappearing concomitantly. Although cerebral tuberculoma is nowadays very rare in Japan, still a high index of suspicion should always be entertained during the investigation of patients showing solitary or multiple enhancing lesions with no or slight degree of perifocal edema on CT, and a trial of antituberculous drugs should be given before the incurable malignancy is presumed or the lesion is explored surgically.