Intracranial tuberculoma : a rare complication of extrapulmonary tuberculosis. Illustrative case

© 2022 The authors..

BACKGROUND: Intracranial tuberculomas are rare entities commonly seen only in low- to middle-income countries where tuberculosis remains endemic. Furthermore, following adequate treatment, the development of intracranial spread is uncommon in the absence of immunosuppression.

OBSERVATIONS: A 22-year-old man with no history of immunosuppression presented with new-onset seizures in the setting of miliary tuberculosis status post 9 months of antitubercular therapy. Following a 2-month period of remission, he presented with new-onset tonic-clonic seizures. Magnetic resonance imaging demonstrated interval development of a mass concerning for an intracranial tuberculoma. After resection, pathological analysis of the mass revealed caseating granulomas within the multinodular lesion, consistent with intracranial tuberculoma. The patient was discharged after the reinitiation of antitubercular medications along with a steroid taper.

LESSONS: To the best of the authors' knowledge, this case represents the first instance of intracranial tuberculoma occurring after the initial resolution of a systemic tuberculosis infection. The importance of retaining a high level of suspicion when evaluating these patients for seizure etiology is crucial because symptoms are rapidly responsive to resection of intracranial tuberculoma masses. Furthermore, it is imperative for surgeons to recognize the isolation steps necessary when managing these patients within the operating theater and inpatient settings.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:4

Enthalten in:

Journal of neurosurgery. Case lessons - 4(2022), 1 vom: 04. Juli, Seite CASE2291

Sprache:

Englisch

Beteiligte Personen:

Letchuman, Vijay [VerfasserIn]
Guillotte, Andrew R [VerfasserIn]
Lundy, Paige A [VerfasserIn]
Dharia, Anand [VerfasserIn]
Lakis, Nelli S [VerfasserIn]
Camarata, Paul J [VerfasserIn]

Links:

Volltext

Themen:

CNS = central nervous system
CSF = cerebrospinal fluid
CT = computed tomography
Case Reports
DWI = diffusion-weighted imaging
Extrapulmonary tuberculosis
Intracranial
MRI = magnetic resonance imaging
Tuberculoma

Anmerkungen:

Date Revised 11.09.2022

published: Electronic-eCollection

Citation Status PubMed-not-MEDLINE

doi:

10.3171/CASE2291

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM343754460