Cerebral tuberculomas
Fredj, M.; Mrabet, H.; Gouider, R.; Mrabet, A.
Revue Neurologique (Paris) 159(8-9): 795-798
2003
ISSN/ISBN: 0035-3787 PMID: 13679725 Document Number: 552883
We report eight cases of brain tuberculoma. The clinical presentation was polymorphous: partial epilepsy (n=4), headache (n=3), hemiplegia (n=1), meningitis (n=1), cerebellar syndrome (n=1). Six patients also had pulmonary tuberculosis, one had tuberculosis of the genital organs, and one had HIV co-infection. The brain CT scan and MRI were highly contributive to diagnosis and follow-up. Despite good compliance with an anti-tuberculosis regimen for at least 14 months, the course was favorable in only six patients. Adjunction of corticosteroids led to radiological improvement. Assessment of cell immunity demonstrated a diminished immunomodulator ratio. Cerebral tuberculoma should be searched for in patients with unexplained neurological manifestations and several intracerebral lesions, particularly if pulmonary or visceral tuberculosis and/or immunodepression is part of the clinical picture.