MULTIPLE CEREBRAL TUBERCULOMAS WITHOUT FOCAL NEUROLOGICAL DEFICIT IN AN IMMUNOCOMPETENT ADULT NIGERIAN: A CASE REPORT (original) (raw)
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Türk Nöroloji Dergisi, 2013
Although tuberculosis of the central nervous system is well known, the incidence of intramedullary tuberculomas is low and a combination of intramedullary with intracranial tuberculomas is extremely rare. We report a case of disseminated tuberculoma involving brain and spine with miliary pulmonary tuberculosis in a 66-year-old woman initially presenting with fever, general weakness, back pain and motor weakness of both lower extremities. Despite medical therapy, she developed progressive motor weakness of both lower extremities with muscle strength 1/5 in both lower extremities. Urgent surgical intervention was followed and her muscle power and motor functions were improved gradually. The antituberculous drugs were continued and the follow-up magnetic resonance imaging (MRI) of brain and spine showed that the lesions had become smaller or disappeared.
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MTB tuberculosis (MTB) is a rare disease. The diagnosis is difficult because of its different presentation. We reported two cases with respiratory and high intracranial pressure symptoms. The cases were diagnosed as MTB tuberculosis associated with brain tuberculomas (Tbms) and abscess formation developed as a complication of tbms, which was the cause of convulsion. The presence of different clinical and radiological findings in a patient with MTB tuberculosis is very rare.
A Case of Rarest Presentation of CNS Tuberculosis as Disseminated Miliary Tuberculoma Brain
2021
Introduction: Disseminated miliary forms of tuberculoma in brain are rarest form of CNS tuberculosis. It is one of the differential diagnoses of ring enhancing multiple brain lesions. We are reporting an interesting case of 28 year old lady with disseminated tuberculosis with miliary brain tuberculomas. Case presentation: 28 yrs lady with no known previous co-morbidities presented with low grade evening rise in temperature and mild to moderate continues global headache for 10 days associted with nausea and recurrent vomiting, and weight loss of 4 kg. Her ESR, blood count, liver and renal function tests were within normal values. HIV was negative by ELISA. Sputum for Acid Fast bacilli was +3 positive for mycobacterium tuberculosis bacilli. Cerebrospinal Fluid cytological analysis was normal and ADA was 9.1 U/L. Urine microscopic examination was positive for +++ MTB. Chest X ray showed bilateral military opacities. High Resolution CT of Chest was suggestive of miliary distribution of ...
Medical Science Case Reports, 2016
Intracranial tuberculoma is one of the rare central nervous system manifestations of Mycobacterium tuberculosis (MTB), seen in only 1% of tuberculosis patients. It can manifest as single or multiple lesions, most commonly located in the frontal and parietal lobes. Clinical features are similar to any spaceoccupying lesion in the brain and can present in the absence of MTB symptoms in other parts of the body. In this article, a 69-year-old immunocompetent man, with history of treated latent tuberculosis infection (LTBI) was reported. He presented with multiple joint arthralgias, weight loss, odd behavior, forgetfulness, intermittent fevers and syncope. Brain imaging revealed numerous enhancing intraparenchymal lesions in cerebral and cerebellar hemispheres. Patient was successfully treated with antituberculosis medications and corticosteroids, with clinical improvement on future follow ups. High clinical suspicion for tuberculoma as a differential diagnosis of any brain lesion, even in immunocompetent patients in low MTB prevalence countries, can result in early diagnosis and successful clinical outcomes.
A Case Review of Intracranial Tuberculoma in an Immune- Competent Young Nigerian Woman
2020
Intracranial tuberculomas are a rare but well-recognized complication of Tuberculosis. It is associated with high disease burden and mortality. The diagnosis of intracranial Tuberculoma remains a challenge in low-income countries and requires a high index of suspicion. We report a case of rare intracranial Tuberculoma in a young Nigerian woman. She presented with focal seizure, crawling sensation and rotatory movement of the left hand. She also had a history of cough and weight loss over three months. The main finding on clinical examination were features of cerebellar dysfunction on the left side. She had a brain CT scan, which showed multiple ring-enhancing hyperdense mass lesion in Right parietal lobe 8.6x6.6mm. The lesion had extensive peri-lesionaloedema with compression of the ipsilateral lateral ventricle, and a shift of parietal lobe to the Right of the midline. There is also an ill-defined isodense lesion in the left cerebellar hemisphere with peripheral ring enhancement on...
Intracranial tuberculoma: a rare complication of extrapulmonary tuberculosis. Illustrative case
Journal of neurosurgery, 2022
BACKGROUND Intracranial tuberculomas are rare entities commonly seen only in low-to middle-income countries where tuberculosis remains endemic. Furthermore, following adequate treatment, the development of intracranial spread is uncommon in the absence of immunosuppression. OBSERVATIONS A 22-year-old man with no history of immunosuppression presented with new-onset seizures in the setting of miliary tuberculosis status post 9 months of antitubercular therapy. Following a 2-month period of remission, he presented with new-onset tonic-clonic seizures. Magnetic resonance imaging demonstrated interval development of a mass concerning for an intracranial tuberculoma. After resection, pathological analysis of the mass revealed caseating granulomas within the multinodular lesion, consistent with intracranial tuberculoma. The patient was discharged after the reinitiation of antitubercular medications along with a steroid taper. LESSONS To the best of the authors' knowledge, this case represents the first instance of intracranial tuberculoma occurring after the initial resolution of a systemic tuberculosis infection. The importance of retaining a high level of suspicion when evaluating these patients for seizure etiology is crucial because symptoms are rapidly responsive to resection of intracranial tuberculoma masses. Furthermore, it is imperative for surgeons to recognize the isolation steps necessary when managing these patients within the operating theater and inpatient settings.
Brain Tuberculomas: A Case Report
Jundishapur Journal of Microbiology, 2014
Introduction: An unusual incidence of tuberculosis in different parts of the body is called tuberculomas. The rate of brain tuberculosis is rare. Case Presentation: The following case of tuberculamas of the brain, presented by enhancing rings of meninges, is reported because of its rarity. It was a case of brain tuberculomas in a 15-year-old girl with primary symptoms of headache and general weakness, and no signs of primary pulmonary infection. Discussion: The subject underwent computerized tomography (CT) and magnetic resonance imaging (MRI) of the brain. Microbiological tests (acid fast bacilli smear-AFB, and culture of biopsy specimen) were applied subsequently. According to the results, the problem was diagnosed as brain tuberculomas. After operation she was completely treated with anti-TB drugs. Although brain tuberculosis is rare, it was diagnosed on the basis of histopathology and the patient's successful response to anti-tuberculous drug treatment.