Central Nervous System Tuberculoma Research Articles

Tuberculome géant du cervelet simulant une tumeur maligne

Isolated central nervous system (CNS) tuberculoma is rare. Central nervous system tuberculosis (TB) is associated with high morbidity and mortality despite modern methods of detection and treatment. The authors report a case of a giant cerebellar tuberculoma mimicking a malignant tumor and review the literature. A six-year-old girl, with no past medical history, vaccinated for her age, presented with a three-month history of occipitocervical cephalalgia, complicated by gait disturbances. The MRI showed a left cerebellar tumor suggestive of a medulloblastoma. At surgery, a nodular, avascular lesion was found and pathological examination confirmed tuberculoma. Intracranial tuberculoma is an uncommon variety of central nervous system tuberculosis. The prognosis is related to the rapidity of diagnosis, surgical resection and the complementary antituberculosis treatment. Intracranial tuberculoma is an uncommon variety of central nervous system infection. Prognosis is improved by a quick diagnosis, surgical removal, and associated antituberculoma therapy.

Central Nervous System Tuberculomas: A Review Article

Central Nervous System Tuberculomas (CNSTs), the most dangerous form of tubercolomas, remains a public health problem, particularly in the developing country. Central nervous system tuberculomas, either single or multiple, usually presents as a diagnostic challenge because it resembles many other infectious and non-infectious medical conditions, particularly in patients without constitutional symptoms or evidence of tuberculosis elsewhere in the body. Here we reviewed the available evidence to answer some of unanswered questions, especially those on the diagnosis and treatment of Central Nervous system tuberculomas. The clinical symptomatology of intracranial tuberculoma was not specific. The CSF profile may be completely normal, even in repeated specimen’s.The MRI was superior to the CT scan in showing not only the location and diagnostic features of tuberculoma, but also in detecting oedema of the brain. Surgical intervention in situation of acute complication of CNSTs, when there was no response to chemotherapy. Prompt diagnosis of Central nervous system tuberculomas result in early treatment and better outcome.

A Case of Disseminated Tuberculosis with Miliary Central Nervous System Tuberculoma

The approach to fever of unknown origin (FUO) is challenging. Through workup and penetrating assessments should be done on the patient to locate the fever focus. Several researches prove that infectious disease still is the most common cause of FUO (1-3). Among the infectious diseases, tuberculosis should always be considered as a possibility, especially in endemic areas. However, physicians often do not consider tuberculosis as a cause of FUO if symptoms are nonspecific and chest radiograph is normal. Disseminated tuberculosis is defined as tuberculous infection involving the blood stream, bone marrow, liver, ≥ 2 noncontiguous sites, or miliary tuberculosis (4). It is due to lymphohematogenous dissemination of Mycobacterium tuberculosis bacilli.

TUBERCULAR MENINGITIS WITH CONCURRENT INTRACRANIAL AND INTRA-SPINAL TUBERCULOMAS

Central nervous system (CNS) tuberculosis commonly manifests as tubercular meningitis CNS tuberculomas are more common intracranially and less frequently involve the spinal cord. We report an unusual case of CNS tuberculosis presented with predominant features of tubercular meningitis with concurrent intra-cranial and intra-medullary tuberculomas in any evidence of pulmonary disease. Most noticeable feature of this patient was lower motor neuron type of bladder involvement in the beginning of clinical deterioration that led to the discovery of intra-spinal tuberculoma.

Clinical and radiological features of symptomatic central nervous system tuberculomas

Tuberculomas may present with meningitis, may lead to meningitis, or may develop during the treatment of TBM. In this study, we report a series of 22 adult cases of symptomatic central nervous system tuberculomas, in eight of them tuberculomas were coexisting with TBM on admission and in 14 of them symptomatic tuberculomas developed during anti-tuberculosis therapy. We also aimed to compare the clinical, laboratory and outcome data of the 14 TBM patients that developed symptomatic tuberculomas, with the data of 41 TBM that did not, under the same treatment regimen. Most of the patients developed symptomatic tuberculomas in the first 6 weeks of treatment. Five patients developed late tuberculomas. The characteristics of tuberculomas and the role of corticosteroids in TBM patients are discussed. In conclusion, although steroids may diminish neurologic symptoms and improve outcome, tuberculomas may appear during the course of anti-tuberculosis and steroid treatment. Because of the possibility of late development of tuberculomas after initial successful treatment, all TBM patients need to be followed-up carefully for a long period.

Retrospective study of 23 pathologically proven cases of central nervous system tuberculomas

Introduction Extrapulmonary manifestations of tuberculosis involving the central nervous system (CNS) due to haematogenous spread are not a rare entity. It presents as meningitis or tuberculoma. Tuberculoma is a granulomatous inflammatory process mimicking a neoplasm radiologically, so usually a biopsy is performed. Material and results Our study consisted of 23 pathologically proven cases of tuberculomas between 1988 and 2003. Patients were discussed clinically, radiologically and histologically. Headache, fever, weight loss and weakness are the most common clinical manifestations. Our patient's ages vary from 3 to 67 years with a mean of 31.8 years. Ninety-five percent of patients had bad social, economic and nutritional conditions. None of them were infected by human immunodeficiency virus (HIV). All patients had similar contrast-enhancing lesions radiologically. The majority of tuberculomas were located supratentorially. Only one patient presented two foci of (cerebral and cerebellar) tuberculomas. Nineteen tuberculomas were intracerebral; two were located in the cerebellum and one was intramedullary. Among those lesions, one cavernous sinus tuberculoma and one sellar tuberculoma were identified. Only two patients underwent stereotactic biopsy and 21 patients underwent surgical excision. Histopathologic examination revealed granulomatous inflammation with central caseous necrosis in all patients. Discussion Diagnosis of tuberculoma can be difficult, and in most of our cases, the clinical diagnosis was ‘neoplasm’. For this reason, clinicians must always be aware of it and consider it in the differential diagnosis of central nervous system mass lesions.

Solitary tuberculoma of the cerebellopontine angle: a rare presentation

Central nervous system tuberculoma presenting as a solitary mass in an extrinsic location is rare. Due to the increase in incidence of tuberculosis in the western world, there is a corresponding increase in CNS tuberculosis. Cerebellopontine angle tumours are most commonly acoustic schwannomas or meningiomas. Radiosurgery as a primary modality of treatment for many CNS masses without prior pathological diagnosis is increasing in popularity. This report shows that a mass in the CP angle can closely mimic a tumour radiologically and inappropriate radiation treatment was avoided after surgery. Histopathological examination proved it to be a tuberculoma. Awareness of this rare presentation of a solitary tuberculoma in the CP angle is emphasised.

Central nervous system tuberculoma: a case report

Pediatric cerebral tuberculoma is a disease rarely encountered in the United States. We report a case of central nervous system tuberculoma in a 6-month-old infant who presented to the emergency department with isolated right upper extremity paralysis. The discussion includes a brief review of central nervous system tuberculomas.

The "target sign": is it a specific sign of CNS tuberculoma?

In brain lesions, the target sign has been defined as a central nidus of calcification or central enhancement surrounded by a ring of enhancement. It has been considered a pathognomonic finding of central nervous system (CNS) tuberculoma. The purpose of this report is to demonstrate that the target sign related to central enhancement is a nonspecific finding and may lead to erroneous diagnosis of CNS tuberculoma.

Central nervous system tuberculoma

Central nervous system tuberculoma

Extrapulmonary Tuberculosis in Saudi Arabia.

ABSTRACT A review of 162 patients with active tuberculosis seen at the King Faisal Specialist Hospital and Research Centre between January 1979 and April 1981 was carried out. Patients with classic...