Ulnar nerve tuberculoma: A case report and literature review

Song, Mingzhi; Sun, Xiaohong; Sun, Ran; Liu, Tao; Li, Gang; Liu, Song; Lu, Ming; Qü, Wei

doi:10.1016/j.jocn.2015.12.047

Cited by 7 publications

(4 citation statements)

References 7 publications

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“…We found that older patients exhibited distinct characteristics compared with younger and middle-aged patients, including a higher clinical stage, poorer prognosis, and longer hospital stays [ 12 ]. The proportion of patients with stages II and III TBM in the older group was significantly higher than that in the younger and middle-aged group, similar to the findings of previous studies [ 13 , 14 ]. Another study reported that the higher the stage, the higher the mortality rate [ 15 ].…”

Section: Discussionsupporting

confidence: 90%

Clinical characteristics of tuberculous meningitis in older patients compared with younger and middle-aged patients: a retrospective analysis

Zhu,

He,

Tong

et al. 2023

BMC Infect Dis

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Background Few studies have analyzed the clinical characteristics and adverse factors affecting prognosis in older patients with tuberculous meningitis (TBM). This study aimed to compare the clinical characteristics of TBM in older patients with those in younger and middle-aged patients. Methods This single-center retrospective study extracted data on the clinical features, cerebrospinal fluid changes, laboratory results, imaging features, and outcomes of patients with TBM from patient medical records and compared the findings in older patients (aged 60 years and older) with those of younger and middle-aged patients (aged 18–59 years). Results The study included 197 patients with TBM, comprising 21 older patients aged 60–76 years at onset, and 176 younger and middle-aged patients aged 18–59 years at onset. Fever was common in both older (81%) and younger and middle-aged patients (79%). Compared with younger and middle-aged patients, older patients were more likely to have changes in awareness levels (67% vs. 40%), peripheral nerve dysfunction (57% vs. 29%), changes in cognitive function (48% vs. 20%), and focal seizures (33% vs. 6%), and less likely to have headache (71% vs. 93%), neck stiffness on meningeal stimulation (38% vs. 62%), and vomiting (47% vs. 68%). The Medical Research Council staging on admission of older patients was stage II (52%) and stage III (38%), whereas most younger and middle-aged patients had stage I (33%) and stage II (55%) disease. Neurological function evaluated on the 28th day of hospitalization was more likely to show poor prognosis in older patients than in younger and middle-aged patients (76% vs. 25%). Older patients had significantly higher red blood cell counts and blood glucose levels, and significantly lower serum albumin and sodium levels than those in younger and middle-aged patients. The cerebrospinal fluid protein levels, nucleated cell counts, glucose levels, and chloride levels did not differ significantly by age. Conclusion In patients with TBM, older patients have more severe clinical manifestations, a higher incidence of hydrocephalus and cerebral infarction, and longer hospital stays than younger and middle-aged patients. Older patients thus require special clinical attention.

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Section: Discussionsupporting

confidence: 90%

Clinical characteristics of tuberculous meningitis in older patients compared with younger and middle-aged patients: a retrospective analysis

Zhu,

He,

Tong

et al. 2023

BMC Infect Dis

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“…According to Prakashvn SA [3], tuberculous bacilli is bloodborne. No typical symptoms of tuberculosis were present in our patient with ulnar nerve tuberculoma.…”

Section: Discussionmentioning

confidence: 99%

“…Tuberculoma is a well-circumscribed, space-occupying lesion [1,2] and tuberculoma involving the peripheral nervous system is rare. Pathogenesis of tuberculoma spreading to peripheral nerves is unclear [1][2][3]. Peripheral nerve involvement usually occurs by direct infiltration from a tubercular lesion involving bone, joints, or lymph nodes [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

“…Pathogenesis of tuberculoma spreading to peripheral nerves is unclear [1][2][3]. Peripheral nerve involvement usually occurs by direct infiltration from a tubercular lesion involving bone, joints, or lymph nodes [1][2][3]. The tuberculoma arises from tubercular foci and starts as a non-caseating granuloma characterized by central multi-nucleated giant cells surrounded by epithelioid cells without central necrosis, but in later stages progresses into caseating granuloma.…”

Section: Introductionmentioning

confidence: 99%

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Management of Ulnar Nerve Tuberculoma: A Challenge to Plastic Surgeon

Maurya¹,

Mir²,

Singh³

2022

Cureus

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Tuberculoma is a well-circumscribed, space-occupying lesion. However, the involvement of peripheral nerves is rare. Here, we report a rare case of left ulnar nerve tuberculoma managed by surgical exploration and tangential excision of tuberculoma lesion sparing, most of the nerve fibers followed by antitubercular treatment. The patient responded well to the management strategy with improvement in motor and sensory activity of the affected limb.

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