Multiple Tuberculomas Research Articles

Tuberculosis of the nervous system: A clinical, radiological and pathological study of 39 consecutive cases in Riyadh, Saudi Arabia

Thirty-seven consecutive adults and 2 children with tuberculosis of the nervous system were studied. Twenty-eight patients (72%) had intracranial or intraspinal tuberculomas and only 11 patients (28%) had tuberculous meningitis. Of the 14 patients (36%) with intracranial tuberculomas 6 presented with epilepsy of late onset including convulsive status epilepticus(2). The 6 patients with multiple tuberculomas some of which were situated in the infratentorial compartment were surprisingly free of major neurological disability or systemic disturbance. Thirteen patients (33%) presented with spinal cord compression due to tuberculoma. Eight of these had associated bony abnormalities such as collapsed vertebrae and loss of pedicles usually regarded as characteristic of malignant disease and 2 presented with clinical features of acute transverse myelitis. Eleven patients (28%) had tuberculous meningitis. One of these died, 1 had a protracted illness with gait ataxia and hydrocephalus and 1 other patient was disabled by hemiplegia, dysphasia and epilepsy but the remaining 8 recovered fully. Tuberculosis outside the nervous system was found in 13 patients (33%) in 12 (31%) of whom it was pulmonary. Acid fast bacilli were demonstrated by Ziehl-Neelsen stain in 16 patients (52%) out of 31 from whom specimens were available. Mycobacterium tuberculosis was eventually cultured from only 6 specimens. These data suggest that the clinical and radiological features of tuberculosis of the nervous system in Saudi Arabia may differ substantially from those reported from other countries. In our study there was low morbidity and low fatality rate. Two patients had infratentorial tuberculomas, and 8 patients had bony abnormalities in the vertebral column, typical of malignant disease.

The far cry of a TB brain: Report of a case of tuberculous meningitis, multiple tuberculomas and tuberculous abscess

An unusual case of neurotuberculosis presenting with tuberculous meningitis, tuberculous abscess and multiple tuberculomas is reported. The patient showed a dramatic response and resolution of tuberculomas with antituberculous therapy only after excision of the abscess.

A Case of Multiple Brain Tuberculoma associated with Miliary Pulmonary Tuberculosis

A Case of Multiple Brain Tuberculoma associated with Miliary Pulmonary Tuberculosis

Diagnosis of Miliary Tuberculosis by Cerebral Computerized Tomography

We report a case of miliary tuberculosis with symptoms and signs of an intracranial mass. These were found to be multiple tuberculomas by computerized axial tomography (CT scan). We review the pathophysiologic features of intracranial tuberculomas. The CT scan allows a rapid and sensitive diagnosis of intracranial tuberculosis without utilizing invasive neurodiagnostic techniques. The value of using CT scans following treatment was confirmed.

Three patients with intracranial tuberculomas with unusual features.

Three patients with verified intracranial tuberculomas are reported. One patient presented with attacks of hydrocephalus initially diagnosed erroneously as migraine, another had multiple tuberculomas and a fourth tuberculoma became apparent during treatment with antituberculous therapy. The third patient presented with a frontal lobe syndrome and the postoperative recovery was complicated by the development of hyperosmolar non-ketotic, non-acidotic diabetic pre-coma. Although there are no pathognomonic symptoms, signs, or radiological appearances of intracranial tuberculomas, a high index of suspicion should always be entertained during the investigation of non-European immigrants.

Tuberculomas cerebrais múltiplos em lactente

É relatado um caso de uma menina com 11 meses de idade, apresentando distrofia de III.º grau, desidratação e processo pleuro-pulmonar grave. Após a hospitalização ocorreu paralisia facial periférica à direita, progredindo e quadro neurológico para paralisia de ambos os nervos motores oculares externos, do pneumogástrico e do glossofaríngeo. Após evolução rápida para o coma, ocorreu o óbito, tendo a autópsia mostrado tuberculose pulmonar, mesentérica e cerebral. O caso é discutido quanto à idade da paciente, à multiplicidade e localização dos tuberculomas encefálicos, ao quadro clínico apresentado, ao encontro de bacilos de Koch nos tuberculomas intracranianos e à normalidade do líquido cefalorraqueano.