Brain Tuberculosis: An Odyssey through Time to Understand This Pathology

Abstract

Tuberculosis is a contagious disease that has been a concern for humanity throughout history, being recognized and referred to as the white plague. Since ancient times, starting with Hippocrates and Galen of Pergamon, doctors and scientists have attempted to understand the pathogenesis of tuberculosis and its manifestations in the brain. If, in the medieval period, it was believed that only the touch of a king could cure the disease, it was only in the early 17th and 18th centuries that the first descriptions of tuberculous meningitis and the first clinico-pathological correlations began to emerge. While the understanding of neurotuberculosis progressed slowly, it was only after the discovery of the pathogenic agent in the late 19th century that there was an upward curve in the occurrence of treatment methods. This review aims to embark on an odyssey through the centuries, from ancient Egypt to the modern era, and explore the key moments that have contributed to the emergence of a new era of hope in the history of neurotuberculosis. Understanding the history of treatment methods against this disease, from empirical and primitive ones to the emergence of new drugs used in multi-drug-resistant tuberculosis, leads us, once again, to realize the significant contribution of science and medicine in treating a disease that was considered incurable not long ago.

Cerebellar Abscess Secondary to Cholesteatomatous Otomastoiditis—An Old Enemy in New Times

“…He published the resolved cases in Pyogenic Disease of the Brain and Spinal Cord: Meningitis, Abscesses of the Brain, Infective Sinus Thrombosis in 1893. In several chapters, he addressed middle ear infections and their complications, such as mastoiditis, leptomeningitis, or cerebellar abscesses [23]. In 1898, in the treatment of cerebellar abscesses, Macewan reported a mortality rate of 55% in nine operated cases, thus demonstrating the lethal nature of this condition and the importance of pus drainage [24,25].…”