Tuberculoma of the brain - A diagnostic dilemma: Magnetic resonance spectroscopy a new ray of hope

Mukherjee, Subhasis; Das, Runa; Begum, Shabana

doi:10.4103/2320-8775.146842

Cited by 29 publications

(34 citation statements)

References 3 publications

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“…The similar appearances of peripheral-or ringenhancing lesions in different conditions has been previously reported, especially in differentiating between neurocysticercosis and brain tuberculomas 9,16,17 . This diagnostic dilemma is made worse by the fact that less invasive tests cannot really exclude neurocysticercosis or brain tuberculomas.…”

Section: Discussionsupporting

confidence: 82%

“…However, these lesions on CT and MRI scans are not specific for PCNSL. Possibilities include other cerebral neoplasms namely glioblastomas 7,8 , as well as infective causes such as neurocysticercosis 9 , brain tuberculomas 9 , cerebral toxoplasmosis 10 , cerebral abscess [11][12][13] , neurological Chagas disease (trypanosomiasis) 14 , cerebral actinomycosis 15 , coccidiomycosis 16 among others. Distinguishing these diagnoses by imaging alone is not easy, which is important given that the different conditions require different management protocols.…”

Section: Introductionmentioning

confidence: 99%

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Multiple peripherally “ring” enhancing lesions of the brain in a young man: A diagnostic dilemma

2018

IJCR

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Multiple peripherally “ring” enhancing lesions of the brain in a young man: A diagnostic dilemma

2018

IJCR

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“…If one or more of these are found to be positive, they can be taken as surrogate evidence favoring a diagnosis of intracranial tuberculoma [7]. …”

Section: Discussionmentioning

confidence: 99%

Brain tuberculoma, an unusual cause of stroke in a child with trisomy 21: a case report

et al. 2017

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BackgroundTuberculosis remains a public health problem in developing countries and is associated with lethal central nervous system complications. Intracranial tuberculomas occur in 13% of children with neurotuberculosis. Patients with trisomy 21 have an increased risk for stroke, which usually stems from cardiovascular defects.Case presentationWe report a case of a 12-year-old Sudanese boy with trisomy 21 who was presented to our hospital with focal convulsions and right-sided weakness. The results of neuroimaging and histopathological examinations were consistent with cerebral tuberculoma. The patient had a good initial response to antituberculosis drugs and steroids. To the best of our knowledge, this is the first case report of multiple brain tuberculomas described in a child with trisomy 21.ConclusionsPatients with trisomy 21 have an increased risk for stroke. Our patient had an exceptional case of stroke caused by tuberculoma. The present case emphasizes the need to consider tuberculomas in the differential diagnosis of children with neurological symptoms living in areas of high tuberculosis incidence.

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“…Previously a single 10 year, retrospective study showed the total of 202 cases with tuberculoma associated with CNS tuberculosis as compared to two year prospective study, which included 93 patients with 28.6% had radiological characteristics of tuberculoma, showing the increment in manifestation of tuberculoma involving central nervous system in Sub-continent region 4,5 . The presentation of Tuberculoma is usually depends upon nature, distribution, site, number and rate of its increasing size, in adults supratentorial location is common as compared to children where infratentorial is much more prevalent [6][7][8] . For the detection and assessment of lesion extension, neuro-imaging like conventional CT scan and MRI is the cornerstone with some definite limitation for the attainment of specificity and confidentiality in the diagnosis of tuberculoma 9,10 .…”

Section: Introductionmentioning

confidence: 99%

“…For the detection and assessment of lesion extension, neuro-imaging like conventional CT scan and MRI is the cornerstone with some definite limitation for the attainment of specificity and confidentiality in the diagnosis of tuberculoma 9,10 . Due to higher negative predictive value of CT scan than MRI, MRI is considered to be better modality for anatomical delineation of tuberculoma, which shows irregular shape, ring-like shapes, open rings, lobular patterns, target like lesions, iso-intense or hypo-intense with a hyper-intense rim and fluidattenuated inversion recovery (FLAIR) images 7,11,12 . Tuberculosis with variable presentation like tuberculoma, which is the rare manifestation of disease is started to appear despite aggressive treatment plans and it holds the disastrous consequences of disability or morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Tuberculoma Brain and its Early Radiological Presentation; Descriptive Analytical Study

2019

J Liaquat Uni Med Health Sci

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OBJECTIVE: To highlight the radiological presentation of tuberculoma brain in association with clinical features of the disease METHODOLOGY: As Descriptive analytical nature of study, it was held in Radiology Department of liaquat University Hospital Hyderabad from June 2018 to December 2018. The cases were referred from medicine and neurosurgery ward to the radiology department for MRI and CT scans. The fillings of questionnaire and co relation of its radiological findings with clinical aspect were examined by evaluating patients file and diagnosed on clinical suspicion, CSF findings, improvement on empirical treatment, diagnosis of exclusion and multi discipline discussion. RESULTS: Total numbers of 20 patients were included, mostly younger age were affected with male preponderance. Mostly cases were presented with meningitis (80%), seizures (60%) and history of tuberculosis (60%). On CT and MRI brain scan, the most common findings were multiple lesions (95%) showed central hyper-intensity on T2 (55%) with meningeal enhancement (80%), fluid-attenuate inversion recovery (FLAIR) signals (35%) and hypo-intense core with hyper-intense rim (30%) reflecting the most of cases with early non caseating nature of tuberculoma. Ring like lesions (80%) and irregular shape (45%) with (25%) target like lesions were found and associated with edema (55%) and calcifications (10%). CONCLUSION: The presentation of tuberculoma is no more a rare manifestation of infective CNS disease. Early identification on scans with characteristics of early non caseating granuloma can help in prompt diagnosis and treatment which in turn decreased the disabling nature of disease and its progression.

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Tuberculoma of the brain - A diagnostic dilemma: Magnetic resonance spectroscopy a new ray of hope

Cited by 29 publications

References 3 publications

Multiple peripherally “ring” enhancing lesions of the brain in a young man: A diagnostic dilemma

Multiple peripherally “ring” enhancing lesions of the brain in a young man: A diagnostic dilemma

Brain tuberculoma, an unusual cause of stroke in a child with trisomy 21: a case report

Tuberculoma Brain and its Early Radiological Presentation; Descriptive Analytical Study

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