Abstract
Tuberculosis is a disease caused by a bacteria named Mycobacterium tuberculosis (M. tb). It is estimated by World Health Organization (WHO) that nearly a quarter of the world’s population is infected. Tuberculoma of the brain is one of the most severe extrapulmonary forms that affects patients younger than 40 years of age. Brain parenchymal tuberculoma develops in nearly one of 300 non-treated cases of pulmonary tuberculosis cases. In endemic regions, tuberculomas account for as many as 50% of all intracranial masses. Tuberculoma results in a hematogenous spread of M. tb from an extracranial source. Tuberculomas can mimic a variety of diseases and can present themselves in a subacute or chronic course, from asymptomatic to severe intracranial hypertension. Diagnosis is based on computed tomography (CT) scan and magnetic resonance imaging (MRI) studies with a similar ring-enhancing lesion. Treatment is primarily medical, and the duration for brain tuberculoma can vary from six to 36 months. In certain cases, surgery is recommended.
Highlights
BackgroundTuberculosis is one of the oldest infectious diseases of human history caused by Mycobacterium tuberculosis (M. tb)
Diagnosis is based on computed tomography (CT) scan and magnetic resonance imaging (MRI) studies with a similar ring-enhancing lesion
This study provides chemical information of major lipid-lactate peaks
Summary
Tuberculosis is one of the oldest infectious diseases of human history caused by Mycobacterium tuberculosis (M. tb). Even if recognized as one of the oldest infectious diseases, it still affects a large amount of the world population, more common in developing countries with the potential to cause disease in almost every tissue of the body, including central nervous system which is one of the most severe forms The objective of this manuscript is to review pathophysiology, diagnosis, clinical features, diagnosis, and treatment of brain tuberculoma, which is a rare entity and is associated with high morbidity and mortality. Despite improvement during the first two weeks of an adequate treatment, brain tuberculous lesions can become larger with worsening of clinical status This phenomenon is known as “paradoxical response”, which seems to be caused by extreme inflammation induced by excessive release of antigens and proinflammatory cytokines produced by M. tb. Most important sequels are neurological impairment due to endarteritis, hydrocephalus secondary to obstruction of CSF and lesion to cranial nerves
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