The far cry of a TB brain

Jain, Varsha; Chandramukhi, A; Venkataramana, N. K.; Das, Bidyutprava; Gokul, B.N.; Rao, T. Vasudev

doi:10.1016/s0303-8467(89)80041-1

Cited by 11 publications

(1 citation statement)

References 1 publication

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“…In developing countries, poor socioeconomic conditions are responsible for endemicity of the disease with higher morbidity and mortality rates, while in developing nations drug abuse and immunocompromised states (like HIV) have contributed to the resurgence of tuberculosis [1]. The two most frequent manifestations of neurotuberculosis are tubercular meningitis (TBM) and intracranial tuberculomas [2, 3]. Approximately 1% of tuberculosis patients develop intracranial tuberculomas [1].…”

Section: Introductionmentioning

confidence: 99%

Paradoxical Response to Chemotherapy in Neurotuberculosis

Kumar¹,

Prakash

Jha

2006

Pediatr Neurosurg

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Objective: Our objective was to investigate the paradoxical response and the factors responsible for such an uncommon (but known) response to chemotherapy in neurotuberculosis. Material and Methods: Ten children with intracranial tuberculomas/neurotuberculosis were retrospectively studied, who were on regular antituberculous chemotherapy. Any deterioration of the neurological condition, increase in the size of the lesion or appearance of new lesions was studied clinically and radiologically during the follow-up period. Results: An atypical response to chemotherapy was observed from 3 weeks to 1 year of chemotherapy. Four of the 10 children, who were receiving chemotherapy for either posttubercular meningitis (TBM), hydrocephalus (2) or TBM (2), developed multiple granulomas in 3 and hydrocephalus in 1 case. The remaining 6 children who were diagnosed to have granulomas at their presentation deteriorated at the follow-up despite regular chemotherapy. CT scans were repeated in 7 of 10 cases at the time of neurological deterioration, out of which 5 children showed appearance of new granulomas or abscess(es) and 2 showed an increase in the size of their preexisting granulomas. One patient with faintly enhancing granulomas in the posterior fossa responded to an additional use of steroids. The remaining 9 patients required surgical intervention on account of their neurological deterioration. Conclusions: (1) Paradoxical responses to intracranial tuberculoma/neurotuberculosis can occur at any time even up to 1 year during chemotherapy despite a regular standard antitubercular treatment. (2) New granuloma(s) or abscess(es) may appear in children receiving chemotherapy for TBM during the follow-up. (3) Hydrocephalus may also appear despite a regular chemotherapy in treated TBM cases. (4) Immature faintly enhancing tuberculomas have a more likely chance of resolution with antituberculous chemotherapy and glucocorticoids, while a well-formed and probably large-sized (>3 cm) granuloma may have a risk of paradoxical enlargement.

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Section: Introductionmentioning

confidence: 99%

Paradoxical Response to Chemotherapy in Neurotuberculosis

Kumar¹,

Prakash

Jha

2006

Pediatr Neurosurg

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Intracranial tuberculous abscess mimicking malignant glioma

et al. 1994

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Brain abscess is probably the least common manifestation of tuberculous infection of the central nervous system; meningitis and tuberculoma are much more common. A case of tuberculous brain abscess in a 23-year-old man with previous history of Tbc meningitis is presented. The computerized tomographic scan demonstrated a unilocular space-occupying lesion in the left thalamic region, surrounded by a thick hyperdense enhancing rim. It is suggested that a relatively long clinical history and previous Tbc meningitis history together with the appearance of a thick-walled abscess-like lesion on the CT scan may indicate the diagnosis of a tuberculous brain abscess. Only after neurosurgical removal of the abscess, the pathohistological examination reveal tuberculous etiology of the abscess. The patient later died from aspiration bronchopneumonia. Only 28 instances of tuberculous abscess have been reported in the literature.

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Suprasellar tubercular abscess presenting as panhypopituitarism: A common lesion in an uncommon site with a brief review of literature

et al. 2006

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Following widespread use of imaging, detection rate of abnormal sites of parenchymal neuro-tuberculosis is on a rise. A handful of cases of tuberculomas/abscesses in hypothalamo-pituitary region have been reported and most of them are diagnosed on surgical histopathology. We describe a patient of suprasellar tubercular abscess, who presented with visual disturbances, diabetes insipidus with panhypopituitarism and on histopathology had granulomas and positive acid fast bacilli.

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The far cry of a TB brain

Cited by 11 publications

References 1 publication

Paradoxical Response to Chemotherapy in Neurotuberculosis

Paradoxical Response to Chemotherapy in Neurotuberculosis

Intracranial tuberculous abscess mimicking malignant glioma

Suprasellar tubercular abscess presenting as panhypopituitarism: A common lesion in an uncommon site with a brief review of literature

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