Miliary tuberculomas of the brain: case report

Clinical Neurology and Neurosurgery
Ahmed AlkhaniBoleslaw Lach

Abstract

Tuberculosis (TB) of the central nervous system (CNS) is still prevalent in many developing countries. Tuberculoma is always considered in the differential diagnosis of enhancing intra-axial lesions of the brain. Brain tuberculomas can present in many different clinical and radiological patterns, disseminated or miliary brain tuberculomas are very rare. We describe the case of a 25-year-old immunocompetent female with miliary brain tuberculomas. She presented with a history of progressive headache and unsteady gait. Serial Magnetic resonance imaging (MRI) studies revealed growing, multiple small enhancing lesions in the brain, most lesions measured approximately 2mm in diameter, in both the supratentorial and infratentorial compartments. Her investigation failed to reveal any evidence of TB outside the CNS. Open biopsy revealed multiple caseating granulomas and mycobacterin tuberculosis was cultured. She improved clinically and radiologically after starting anti-tuberculous pharmacotherapy. The clinical course, radiological images and pathological studies of this patient are presented. In conclusion miliary brain tuberculomas are rare and unique clinical and radiological entity. It may affect immunocompetent individuals with no...Continue Reading

References

Nov 1, 1992·AJR. American Journal of Roentgenology·G T GeeJ R Jinkins
Jan 1, 1983·European Neurology·M TrautmannO Brückner
Mar 1, 1980·Journal of Neurosurgery·P R GonzálezP G Loyzaga

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Citations

Aug 2, 2013·QJM : Monthly Journal of the Association of Physicians·F-F TsaiH-M Tai
Dec 25, 2009·Clinical Neurology and Neurosurgery·Ravindra Kumar GargRajesh Verma
Oct 20, 2007·Journal of the Neurological Sciences·Ravindra Kumar GargAlok Mohan Kar
Aug 20, 2021·Transactions of the Royal Society of Tropical Medicine and Hygiene·Vijeth L UrsHardeep Singh Malhotra

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