Free Content Tuberculoma of the brain: a series of 16 cases treated with anti-tuberculosis drugs

Authors: Idris, M.N.A.1; Sokrab, T-E.O.2; Arbab, M.A.R.1; Ahmed, A.E.M.1; El Rasoul, H.1; Ali, S.1; Elzubair, M.A.1; Mirgani, S.M.1

Source: The International Journal of Tuberculosis and Lung Disease, Volume 11, Number 1, January 2007 , pp. 91-95(5)

Publisher: International Union Against Tuberculosis and Lung Disease

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Abstract:

OBJECTIVES: To describe the clinical presentation, radiological findings and outcome of treatment with anti-tuberculosis drugs in 16 cases of intracranial tuberculoma.

DESIGN: Consecutive cases admitted with tuberculoma to the National Center for Neurological Diseases in Khartoum, Sudan, were included in the study. The diagnosis was based on clinical and neuro-imaging features and response to anti-tuberculosis treatment. Histopathology of material from the brain or other extracranial tissues was available in seven cases.

RESULTS AND CONCLUSIONS: The commonest presenting features were headache (100%), generalized convulsions (68.7%) and hemiparesis (56.2%). Computerised axial tomography/magnetic resonance imaging (CT/MRI) showed single or multiple lesions that showed intense contrast enhancement and perilesional edema. The lesions completely cleared on anti-tuberculosis treatment in the majority of survivors (13/15). Partial clearance of lesion was associated with late presentation, multiple large lesions and advanced miliary disease. We advocate early empirical trial of anti-tuberculosis drugs for intracranial tuberculoma even after a presumptive diagnosis, particularly in areas where the infection is endemic.

Keywords: intracranial tuberculoma; anti-tuberculosis drugs; Sudan

Document Type: Regular paper

Affiliations: 1: Faculty of Medicine, University of Khartoum, Khartoum, Sudan 2: Faculty of Medicine, University of Khartoum, Khartoum, Sudan; and Hamad General Hospital, Doha, Qatar

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