Brain-Stem Tuberculoma

Abstract

To the Editor. —It is with interest that we read the article entitled Brain-Stem Tuberculoma, An Analysis of 11 Patients written by Talamas et al1that appeared in the May 1989 issue of theArchives. It is a well-known fact that the diagnosis of central nervous system tuberculosis is a very difficult one, especially because of the wide variety of clinical presentation of this disease. Recently, the development of neuroimaging methods and several immunological techniques, including the enzyme-linked immunosorbent assay method, for tuberculous antigens, has increased the accuracy of this diagnosis. However, there are still some cases in which the definitive diagnosis has to be made through brain or meningeal biopsy specimens. Of the 11 cases presented in this article, only in one patient was the diagnosis proved through histological findings, and in the remaining 10 patients, it was supported or inferred through clinical presentation, cerebrospinal fluid analysis, computed