1/48. Spectroscopic increase in choline signal is a nonspecific marker for differentiation of infective/inflammatory from neoplastic lesions of the brain.We report in vivo proton magnetic resonance (MR) spectroscopic findings in three benign infective/inflammatory lesions (one case each of tuberculoma, fungal granuloma, and xanthogranuloma), which showed high choline along with the presence of lipid/lactate, a feature characteristically described in neoplastic lesions. Histopathology of the lesions showed inflammatory cellular infiltrates with areas of necrosis/caseation. The spectroscopic-visible increased choline resonance in these lesions is probably the result of cellularity. We conclude that increased choline, along with the presence of lipid/lactate is a nonspecific finding and may not be of much value in the differentiation of neoplastic from nonneoplastic infective/inflammatory intracranial mass lesions.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/48. tuberculoma of the conus medullaris: case report.OBJECTIVE AND IMPORTANCE: Intramedullary spinal tuberculoma is a rare form of central nervous system tuberculosis. This article describes an affected patient who presented with left leg paresis. CLINICAL PRESENTATION: A 46-year-old man presented with a 7-day history of left leg weakness. The patient's medical history included infection with pulmonary tuberculosis 15 years previously, at which time he had been treated with antituberculosis therapy. The neurological examination performed at admission revealed left leg paresis with Grade 2/5 power in all muscle groups. The patient reported no urinary or bowel problems. INTERVENTION: Surgery was performed with the patient in the prone position. The procedure involved laminectomies at T11, T12, and L1, followed by a midline myelotomy. The mass was excised completely. Histopathological examination revealed a granulomatous lesion that contained Langhans' giant cells, inflammatory cells, and evidence of caseating necrosis. The patient was prescribed a 6-month course of antituberculosis therapy with pyrazinamide, isoniazid, and rifampin. CONCLUSION: The outcome was favorable. Recently, a number of authors have reported success with medical management of intraspinal tuberculoma. Intraspinal tuberculoma produces a mass effect that can jeopardize spinal cord function. The optimal treatment is a combination of microsurgical resection and antituberculosis chemotherapy.- - - - - - - - - - ranking = 0.72367585873244keywords = central nervous system, nervous system (Clic here for more details about this article) |
3/48. Cervical intramedullary tuberculoma: acute presentation and rapid response to medical therapy.A case of an 11-year-old boy with rapidly progressing quadriparesis with bowel and bladder incontinence is reported. MRI of the spine revealed an intramedullary tuberculoma at the level of C5-7. Investigations further revealed evidence of tuberculosis in the brain and lungs as well. The child made a rapid recovery with medical management alone.- - - - - - - - - - ranking = 0.25keywords = brain (Clic here for more details about this article) |
4/48. Multiple tuberculomas of the brain. Report of a case.A case of multiple tuberculomas of the brain in a pregnant patient is reported. The symptoms and signs suggested a lesion of the cerebellum which was found to be only congested and oedematous at craniotomy. The correct diagnosis was made at autopsy.- - - - - - - - - - ranking = 1.25keywords = brain (Clic here for more details about this article) |
5/48. Multiple tuberculomas in the brain and spinal cord: a case report.STUDY DESIGN: A case of disseminated tuberculoma in the spinal cord and brain is reported. OBJECTIVES: To present a case of disseminated tuberculoma in the spinal cord and brain and to describe the unusual pathologic features and clinical presentation. SUMMARY AND BACKGROUND: DATA Intramedullary tuberculoma concomitant with intracerebral disseminated tuberculoma is rare. Only one other case has been reported in the world literature. This represents the second reported case of this unusual lesion. MATERIALS AND methods: The authors report a 67-year-old man with miliary tuberculosis of the lung and started on antituberculous therapy. His pulmonary complaints were resolved, but he presented acute paraparesis caused by tuberculomas in the thoracolumbar spinal cord. MRI showed more tuberculomas in the brain stem, cerebellum, and cerebral hemispheres. RESULTS: After 6 months, the patient's muscle power gradually improved with a combination of medical and surgical management. CONCLUSIONS: Our experience indicates that antituberculous medication is effective in managing multiple central nervous system tuberculomas. The purpose of surgical intervention is to decompress the cord or brain when progressing neurologic defects occur and to examine the tissue pathologically.- - - - - - - - - - ranking = 2.7236758587324keywords = central nervous system, brain, nervous system (Clic here for more details about this article) |
6/48. Spinal intramedullary tuberculoma requiring surgical treatment--case report.A 71-year-old male presented with multiple central nervous system tuberculomas including spinal intramedullary tuberculoma manifesting as occipitalgia and left hemiparesis. He had received medical treatment for lung and testis tuberculosis. magnetic resonance imaging revealed an intramedullary lesion at the C-2 level as well as multiple small extramedullary and intracranial lesions. His neurological symptoms gradually worsened despite intensive antituberculous therapy. The C-2 intramedullary lesion responsible for left hemiparesis was surgically extirpated. Postoperatively, his neurological symptoms improved gradually, and no recurrence was evident at the resected site. Surgical intervention is mandatory in patients with intramedullary tuberculoma if neurological symptoms deteriorate or lesions enlarge despite continuous antituberculous therapy.- - - - - - - - - - ranking = 0.72367585873244keywords = central nervous system, nervous system (Clic here for more details about this article) |
7/48. Concurrent intra-medullary and intra-cranial tuberculomas.Although tuberculosis of the central nervous system is well known, the incidence of intra-medullary tuberculomas is low and a combination of intra-medullary with intra-cranial tuberculomas is extremely rare. This communication reports a case of disseminated (intra-medullary, intra-cerebellar and intra-cerebral) tuberculomas in a six-year-old girl initially presenting with a spinal tumour syndrome. Conservative treatment with anti-tuberculous medications and a short course of injectable steroids resulted in complete resolution of her symptoms.- - - - - - - - - - ranking = 0.72367585873244keywords = central nervous system, nervous system (Clic here for more details about this article) |
8/48. Intramedullary tuberculoma mimicking primary CNS lymphoma.The incidence of primary central nervous system lymphoma (PCNSL) has been on the rise in the setting of immunodeficiency syndromes such as acquired immune deficiency syndrome (AIDS). Its diagnosis has been facilitated by the advent of a cerebrospinal fluid (CSF) Epstein-Barr virus (EBV) PCR assay. The reported high sensitivity and specificity of this assay has made it the cornerstone of diagnosis of PCNSL, replacing more traditional methods such as an open CNS biopsy. Here, we have described a patient with a known history of C3 AIDS presenting with lower extremity weakness and eventual myelopathy who was later diagnosed as having intramedullary PCNSL after detection of EBV dna in his CSF. After failing to respond to radiotherapy, he underwent a spinal cord biopsy revealing intramedullary tuberculoma. This case illustrates the risk of misdiagnosis with this assay and the importance of histological confirmation of a pathological lesion prior to implementation of therapy.- - - - - - - - - - ranking = 0.72367585873244keywords = central nervous system, nervous system (Clic here for more details about this article) |
9/48. Intramedullary spinal tuberculoma: report of three cases.BACKGROUND: Intramedullary spinal tuberculoma is a rare form of central nervous system tuberculosis. This article describes the successful management of intramedullary spinal tuberculoma in 3 patients who received treatment between 2000 and 2003. CASE DESCRIPTION: The character of 3 cases was analyzed retrospectively, including clinical manifestation and magnetic resonance imaging findings. All masses were excised totally under microscope. Histopathologic examination revealed tuberculoma. Postoperatively, all patients received a 6 to 9 month course of ATT. The outcome was favorable. CONCLUSIONS: The intramedullary spinal tuberculoma must be considered in the differential diagnosis of the spinal cord compression in patients with a history of tuberculosis. When confronted with a progressing neurologic deficit and poor response to ATT, surgical intervention should be considered. The optimal treatment is a combination of microsurgical resection and ATT.- - - - - - - - - - ranking = 0.72367585873244keywords = central nervous system, nervous system (Clic here for more details about this article) |
10/48. Brainstem tuberculoma presenting as eight-and-a-half syndrome.We present a case of a young child who developed eight-and-a-half syndrome following a pontine tuberculoma, an unusual complication of central nervous system tuberculosis not previously described in an immunocompetent child. The combination of clinical findings allowed for precise localization of the lesion whilst magnetic resonance T1 weighted imaging with contrast provided valuable etiological information. We also discuss the management and outcome of the case.- - - - - - - - - - ranking = 0.72367585873244keywords = central nervous system, nervous system (Clic here for more details about this article) |
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