[Encephalic tuberculoma. 40 cases]

In this retrospective study, the authors analyse 40 cases of encephalic tuberculomas collected between 1973 and 1991. Most of the patients were young and four out of five were less than 30 years old. The intracranial hypertension syndrome was predominant (75% of the cases). Topographic diagnosis of the space-occupying process was established by arteriography in 13 cases, but a more precise approach to the nature of the lesion could only be obtained by CT (27 cases). The supratentorial localization predominated in 70% of the cases. 16% of the lesions were multiple and 7 patients had developing extracranial tuberculosis. All the patients received medical treatment associating 3 antibacillary agents. Twenty-five patients underwent surgery, 23 of these for diagnostic purpose and 2 following the failure of the isolated medical treatment. Five patients (12.5%) died after a prolonged coma. Recovery was achieved in 50% of the patients. Fifteen of these patients (37.5%) still have neuro-ophthalmologic sequelae.