The clinical features of intracranial tuberculoma and surgical treatment

Abstract

Objective To investigate the clinical characteristics of intracranial tuberculoma and its diagnosis and outcomes of surgical treatment. Methods In this retrospective study, clinical data including manifestations, imaging, laboratory tests and surgical outcomes of 8 adults were analyzed who were consecutively identified with intracranial tuberculoma from August 2013 to April 2016 at Department of Neurosurgery, Beijing Ditan Hospital, Capital Medical University. Results Among the 8 patients with intracranial tuberculoma, the human immunodeficiency virus (HIV) infection was identified in 4 cases and tuberculosis (TB) involving other systems was found in 3 cases. Out of the 8 patients, lesions were supratentorial in 5 cases and located in posterior fossa of the remaining 3 cases. Seven cases underwent total resection and stereotactic biopsy was performed in 1 case. Pathological acid-fast stain demonstrated positive results and confirmed the diagnosis of tuberculoma. All the patients were regularly treated with anti-tuberculosis drugs. One case died from HIV-related complications 1 year post operation and the rest recovered well. Conclusions The clinical characteristics of intracranial tuberculoma vary depending on its location. The supratentorial tuberculoma commonly caused epilepsy and headache and the subtentorial lesion often presented with symptoms related to high intracranial pressure due to hydrocephalus. The diagnosis should be based on a combination of clinical manifestations, imaging features, laboratory examination and anti-tuberculosis efficacy. With strict following of its indications, surgical treatment might be effective. Key words: Tuberculoma, intracranial; Disease attributes; Neurosurgical procedures