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Brainstem tuberculoma

Kamini Gupta, Avik Banerjee, Kavita Saggar, Archana Ahluwalia, Karan Saggar
BACKGROUND: Infections of the central nervous system (CNS) are common and routinely encountered. Our aim was to evaluate the neuroimaging features of the various infections of the CNS so as to differentiate them from tumoral, vascular, and other entities that warrant a different line of therapy. AIMS: Our aim was to analyze the biochemical and magnetic resonance imaging (MRI) features in CNS infections. SETTINGS AND DESIGN: This was a longitudinal, prospective study over a period of 1½ years...
January 2016: Journal of Pediatric Neurosciences
Dana A Muin, Katrin Wagner, Rosemarie Burian, Naghmeh Ghaem Maghami, Olav Lapaire
We report a case of a Somali refugee who presented in the second trimester of her first pregnancy with a four-week history of gradual right-sided sensomotoric hemisyndrome including facial palsy and left-sided paresis of the oculomotorius nerve causing drooping of the left eyelid and double vision. Cranial magnetic resonance imaging revealed a solitary brainstem lesion. Upon detection of hilar lymphadenopathy on chest X-ray (CXR), the diagnosis of disseminated tuberculosis with involvement of the central nervous system was confirmed by PCR and treatment induced with rifampicin, isoniazid, pyrazinamide, and ethambutol...
2015: Case Reports in Obstetrics and Gynecology
George A Demetriou
We present a case of a 38-year-old-man who presented with 1-week history of developing weakness of peripheral and cranial nerves. His MRI scan of the brain showed a large cavitating lesion at the brainstem and two further lesions of the right cerebral cortex and his CT chest showed features of old tuberculosis (TB). The identification of acid-fast bacilli was confirmed by analysis of bronchoalveolar lavage taken during bronchoscopy. He was started on anti-TB medications and repeat MRI 3 months later confirmed shrinkage of the cavitating lesion...
July 18, 2013: BMJ Case Reports
Jennifer L Lyons, Martha R Neagu, Isaiah H Norton, Joshua P Klein
Integrity of descending white matter tracts can be evaluated by diffusion tensor imaging. In rim-enhancing intraparenchymal lesions, this technique can assist in the differentiation of demyelinating disease from tumor or abscess. Diffusion tensor imaging characteristics of tuberculoma have not been previously reported to our knowledge. A patient with headaches, dizziness, and mild left-sided weakness underwent MRI with diffusion tensor imaging. A large, rim-enhancing lesion within the pons was discovered, which subsequently was diagnosed as tuberculoma...
November 2013: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Oscar H Del Brutto, Victor J Del Brutto
OBJECTIVE: Review of patients with isolated brainstem cysticercus to outline the features of this form of neurocysticercosis. METHODS: MEDLINE and manual search of patients with isolated brainstem cysticercus. Abstracted data included: demographic profile, clinical manifestations, neuroimaging findings, evolutive stage of parasites neurocysticercosis, therapy, and follow-up. RESULTS: Twenty-nine patients were reviewed. Of these, 22 (76%) came from India...
May 2013: Clinical Neurology and Neurosurgery
Pengfei Ge, Xiaojie Zhang, Yangping Zhong, Xinchao Bian, Shuanglin Fu, Yinan Luo
Formation of tuberculoma is a rare response of neurotuberculosis in patients regularly and adequately treated with anti-tuberculous drugs. We report a 13-year-old girl with two tuberculomas which formed in the dorsal part of the medulla oblongata during chemotherapy for tuberculous meningitis. The tuberculomas were both removed via a suboccipital midline approach and were demonstrated by pathological findings but the girl died of cardiac arrest that was thought to be caused by postoperative medulla oblongata oedema...
September 2012: Neurologia i Neurochirurgia Polska
Hitesh K Gurjar, Shejoy P Joshua, Deepak Agrawal, Ashok K Mahapatra
Tuberculosis of the central nervous system (CNS) is a life threatening condition with 50% mortality in advanced disease and serious neurological deficits in those who survive. Tuberculous abscess is a rare manifestation of CNS tuberculosis, brainstem involvement being even rarer. The management of these conditions poses a great challenge to the treating physician. We report a case of large tubercular abscess of pons which increased in size on anti-tubercular treatment, but showed excellent improvement following craniotomy and aspiration...
February 2013: British Journal of Neurosurgery
Yaxiong Li, Yuekang Zhang, Jianguo Xu, Ni Chen, Zhongxin Zhao
No abstract text is available yet for this article.
June 2012: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Liaqat Ali Chaudhry, Ebtesam Ba-Essa, Shehab Al-Solaiman
Milliary Tuberculosis (TB) occurs through lymphohaematogenous dissemination of M. tuberculosis and paradoxical response (PR) is a recognized feature. Respiratory failure, choroid tubercles and brain tuberculomas are some of the complications. Brain tuberculomas mainly occur in the cerebrum, cerebellum, where as involvement of the brainstem is rare. A 31 years old female presented with history of ill health, easy fatigability, excessive sweating and fever of one month duration, dry cough for one week and shortness of breath for 3 days...
January 2012: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Jee-Young Lee, Jae-Joon Yim, Byung-Woo Yoon
Tuberculosis (TB) of the brain is often refractory and has the highest morbidity and mortality among the mycobacterial infections. A recent report suggests that interferon-γ may be of help since it can modulate the host inflammatory response against mycobacteria in the brain. Here, we report on a 44-year-old woman with multiple tuberculomas in the brainstem and a 40-year-old man with two large TB abscesses in the brain, both of whom had no response to anti-TB medications for 5 and 7 months, respectively, but with near-complete resolution with adjuvant interferon-γ therapy (50 μg/m(2), subcutaneously, three times per week)...
July 2012: Clinical Neurology and Neurosurgery
R Verma, P Sharma
Brainstem tuberculomas are quite unusual, accounting for less than 5 % of all intracranial tuberculoma. Intracranial tuberculoma is rare form of central nervous system tuberculosis. Lateral medullary syndrome is a combination of clinical features commonly attributed to infarction in territory of posterior inferior cerebellar artery or vertebral artery. We report a case suffering from lateral medullary syndrome resulting from brainstem tuberculoma which has not been reported so far in the literature. This patient was started on antituberculous chemotherapy and repeat magnetic resonance imaging of the cranium revealed regression of the lesion...
June 2011: Journal of the Association of Physicians of India
Fuldem Yildirim Donmez, Mehmet Coskun, Gulnur Guven
Tuberculomas are common forms of central nervous system tuberculosis, presenting as space-occupying-lesions. Brainstem tuberculomas are rare among all intracranial tuberculomas. In old patients, in the absence of tuberculosis history, diagnosis may be challenging. In this case, we present a 70-year-old patient, with bladder cancer, without known tuberculosis who presented with stroke-like symptoms, clinically. Diffusion-weighted imaging revealed no finding of stroke, however, a medulla oblongata tuberculoma, mimicking metastasis was evident on MRI...
August 2009: Neurological Sciences
R P G Molenaar, C L Jansen, M J B Taphoorn
A 30-year-old man and a 37-year-old woman with no history of tuberculosis developed symptoms of headache, vomiting and subsequent aggressive behaviour. After several lumbar punctures, the PCR test for tuberculosis in the cerebrospinal fluid was positive, and a definitive diagnosis of tuberculous meningitis was made. Treatment with antimycobacterial agents was not started until a few days after hospital admission. The man recovered, but was treated for brainstem tuberculoma 12 months later; the woman died on day 11 of hospitalisation...
March 15, 2008: Nederlands Tijdschrift Voor Geneeskunde
Guner Sonmez, Ersin Ozturk, H Onur Sildiroglu, Hakan Mutlu, Ferhat Cuce, M Guney Senol, Ali Kutlu, C Cinar Basekim, Esref Kizilkaya
PURPOSE: Tuberculosis involvement of the central nervous system continues to represent a serious problem, particularly in developing countries. The aim of this study was to characterize the magnetic resonance imaging (MRI) findings of intracranial tuberculoma, a form of neurotuberculosis. METHODS: We retrospectively reviewed the data of 27 patients with intracranial tuberculomas. These consisted of 17 women and 10 men with a mean age of 26 years (14-51). MRI was performed on all patients...
March 2008: Clinical Imaging
Soma Sahaiu-Srivastava, Brenda Jones
Brainstem tuberculoma is an uncommon entity especially in the immunocompetent adult. The authors describe the case of a 32-year-old immunocompetent woman with no systemic signs or symptoms of tuberculosis, presenting with sudden-onset hemiparesis and diplopia. MRI of brain revealed an enhancing lesion in the midbrain and thalamus. Cerebrospinal fluid examination was normal. Chest imaging was consistent with miliary tuberculosis; however initial expectorated sputum was culture negative. Bronchosopy sputum culture was positive for Mycobacterium tuberculosis...
March 2008: Clinical Neurology and Neurosurgery
Ronald van Toorn, Johan F Schoeman, Peter R Donald
We present a case of a young child who developed eight-and-a-half syndrome following a pontine tuberculoma, an unusual complication of central nervous system tuberculosis not previously described in an immunocompetent child. The combination of clinical findings allowed for precise localization of the lesion whilst magnetic resonance T1 weighted imaging with contrast provided valuable etiological information. We also discuss the management and outcome of the case.
January 2006: European Journal of Paediatric Neurology: EJPN
Jairo Lizarazo
Two cases of appearance of encephalic tuberculomas during anti-tuberculous treatment in immunocompetent patients are presented. The first an adult man presenting a right frontal lesion which required surgical treatment and the second a girl with multiple lesions located mainly in the brainstem. This paradoxical presentation is attributed to a bizarre immunological reaction between the host and the tuberculosis bacillus. Patients with this condition do not require changes in anti-tuberculous treatment, and steroids are helpful in alleviating the symptoms...
June 2004: Biomédica: Revista del Instituto Nacional de Salud
Vimla Menon, Madhurjya Gogoi, Rohit Saxena, Sumit Singh, Arvind Kumar
A seldom reported causal association of two rare entities, an isolated brainstem tuberculoma and an isolated One and a half syndrome in a 12 year old girl is presented. MRI showed an isolated inflammatory granuloma in the brainstem which on empirical treatment with anti tubercular drugs resulted in complete restoration of ocular motility, along with resolution of the lesion on follow up MRI at 6 months. The diagnosis and management are discussed.
May 2004: Indian Journal of Pediatrics
David Débat Zoguéreh, Catherine Andrieux, Adoum Abakar, Michel Robineau
The numerous extrapulmonary manifestations of tuberculosis have been well described. Intracranial localizations, including brain stem tuberculoma, are very rare. The authors report a case of brain tuberculoma in a patient with a history of primary pulmonary tuberculosis successfully treated more than twenty years earlier. The patient presented with signs of infection, although the fever disappeared temporarily after successive treatments for malaria (confirmed Plasmodium faiciparum), as well as neurological signs with left hemiparesis...
July 2003: Santé: Cahiers D'étude et de Recherches Francophones
R K Moorthy, V Rajshekhar
A 23-year-old man with cyanotic heart disease, presented with a ring-enhancing mass in the brainstem. Stereotactic intervention for this clinically and radiologically diagnosed pyogenic abscess, revealed a tuberculoma. Antituberculous therapy led to complete recovery. Stereotactic intervention is an ideal management strategy in patients with cyanotic heart disease and an isolated ring-enhancing mass in the brainstem.
September 2003: Neurology India
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