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

• Published in: The international journal of tuberculosis and lung disease Vol. 11; no. 1; pp. 91 - 95
• Main Authors: IDRIS, M. N. A, SOKRAB, T.-E. O, ARBAB, M. A. R, AHMED, A. E. M, EL RASOUL, H, ALI, S, ELZUBAIR, M. A, MIRGANI, S. M
• Format: Journal Article
• Language: English
• Published: Paris, France IUATLD 01.01.2007; Union internationale contre la tuberculose et les maladies respiratoires
• Subjects: Adolescent; Adult; Anti-Tuberculosis Drugs; Antitubercular Agents - therapeutic use; Bacterial diseases; Biological and medical sciences; Female; Human bacterial diseases; Humans; Infectious diseases; Intracranial Tuberculoma; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Miscellaneous; Pneumology; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Sudan; Tomography, X-Ray Computed; Treatment Outcome; Tuberculoma - diagnosis; Tuberculoma - drug therapy; Tuberculoma, Intracranial - diagnosis; Tuberculoma, Intracranial - drug therapy; Tuberculosis and atypical mycobacterial infections; Africa; Sudan; Pseudotumor; Human; Drug; Intracranial; Central nervous system; Sudan; Tuberculoma; intracranial tuberculoma; Mycobacterial infection; anti-tuberculosis drugs; Encephalon; Infection; Symptomatology; Tuberculosis; Treatment; Bacteriosis; Tumor; Antituberculous agent; Antibacterial agent; Pneumology
• ISSN: 1027-3719; 1815-7920

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.