Hematogenous spread from tuberculous lesions of other parts of the body represent the origin of intracranial tuberculomas. In most series of the literature, the cerebellum has about two thirds and the cerebral hemispheres about one third of the intracranial tuberculomas. It may occurs as a single lesion, but multiple intracranial tuberculomas varies from 10% to 33% of the cases due to the hematogenous spread. Calcium deposits are rare, occurring in about 6% of cases. Ramamurthi and Varadarajan described the two types of the intracranial tuberculoma; 1. Superficial and vascular type, produces early focal signs of increased intracranial pressure. 2. deep and avascular type, accompanied by signs of increased intracranial pressure. We have been experienced in one case of symmetrical and bilateral cerebellar tuberculomas probably originated from the pulmonary lesion.
Calcium ; Cerebellum ; Cerebrum ; Intracranial Pressure ; Tuberculoma* ; Tuberculoma, Intracranial

BACKGROUND: Paradoxical intracranial tuberculoma is tuberculoma that developed or was enlarged during antituberculous therapy. The course of the disease or effective treatment are not well known. METHOD: Patients who developed intracranial tuberculoma or an enlarged tuberculoma during antituberculous therapy were investigated. Ten patients were enrolled. RESULTS: Paradoxical intracranial tuberculoma was detected 67.9 days after antituberculous therapy. The symptoms worsened over a period of 102.3 days. Improvement was noted after 165.4 days. Four patients recovered on the brain image and 4 recovered clinically. The CSF findings showed that the paradoxical tuberculomas had developed or were aggravated, the CSF findings was aggravated. CONCLUSION: Paradoxical intracranial tuberculoma can develop without specific symptoms. Paradoxical intracranial tuberculoma may not be a paradoxical response and may be a natural course of intracranial tuberculosis or a natural response to antituberculous therapy.
Brain ; Drug Therapy* ; Humans ; Tuberculoma ; Tuberculoma, Intracranial ; Tuberculosis

Intracranial tuberculomas have been reported occasionally, especially in Asia, though much decreased in recentyears. Those lesions can be diagnosed more easily and acurately using CT than conventional method, including angiography. Authors analysed CT findings of 21 cases, confirmed as tuberculoma, at Hanyang University Hospital from May 1979 to June 1983. The resuslts were as follows; 1. Of all 21 cases, multiple lesions were seen in 14 cases (67%) and single in 7(33%). 2. Of all 21 cases, lesions located only at supratentorial were in 19 cases(90%) and remained 2(10%) had lesions at both supra and infratentorial area. And temporal and parietal lobes were common location (65%) of all lesions. 3. In precontrast scan, density of tuberculoma showed largely isodense (68%)and others were slight high (29%) and low(3%). 4. All lesions were enhanced showed as homogeneous nodular (68%),ring-shaped(29%) and target shaped(3%). 5. All rings were continuous and thickness was largely uniform(67%), anddensity of center of the ring was mainly low(67%). 6. Edema was seen in 58% of all lesions: comparing with thesize of tuberculoma, edema size was smaller in 50%, lager in 33% and almost the same in 17%.
Angiography ; Asia ; Edema ; Methods ; Parietal Lobe ; Tuberculoma ; Tuberculoma, Intracranial

Intracranial tuberculoma may imitate, both clinically and radiologically, the more commonly observed intracranial tumors. A 16 year old female patient was admitted due to exophthalmus(o.d) and headache. Neurologically papilledema was noted on the both fundus and exophthalmometry revealed that exophthalmus(17mm, 13mm). CT brain scan showed slightly high density lesion with surrounding low density in right frontotemporal area, attached to the sphenoid bone. And also hyperostosis was noted at the right sphenoid bone and dense homogeneous enhancement of mass after contrast infusion was seen. This case reports outlines the development of such a lesion masquerading as a typical meningioma of the sphenoid ridge. Discussion of intracranial tuberculoma follows, with special reference to clinical and radiological findings.
Adolescent ; Brain ; Female ; Headache ; Humans ; Hyperostosis ; Intracranial Pressure ; Meningioma* ; Papilledema ; Sphenoid Bone ; Tuberculoma* ; Tuberculoma, Intracranial

As a cause of spinal cord compression, intramedullary spinal tuberculoma with central nervous system (CNS) involvement is rare. Aurthors report a 66-year-old female presented with multiple CNS tuberculomas including spinal intramedullary tuberculoma manifesting paraparesis and urinary dysfunction. We review the clinical menifestation and experiences of previous reported literature.
Aged ; Central Nervous System ; Female ; Humans ; Paraparesis ; Spinal Cord Compression ; Tuberculoma ; Tuberculoma, Intracranial ; Tuberculosis

The authors describe a case of pituitary tuberculoma in 45 year old female patient with previous history of tuberculous meningitis. Her clinical complaints were headache, visual field defects and amenorrhea. Endocrinological studies showed hypopitutitarism. Radiological studies including CT showed tumor mass in the sella turcica and suprasella area & paietal lobe. Ramamurthi and Varadarajan described the two types of the intracranial tuberculoma ; 1) A superficial and vascular type requires operation only in selected cases and it responds favoratly to treatment. 2) A deep and avascular type accompanied by increased intracranial tension and a spaecoccupying lesion, which does not respond to medical treatment and requires operation. Removal of the pituitary tuberculoma by T.S.A. followed by antituberculous treatment resulted in resolution of her neurological symptoms and signs.
Amenorrhea ; Female ; Headache ; Humans ; Middle Aged ; Sella Turcica ; Tuberculoma* ; Tuberculoma, Intracranial ; Tuberculosis, Meningeal ; Visual Fields

Although a paradoxical response of tuberculosis to antituberculous therapy is not a rare phenomenon, it can be a clinical challenge to differentiate a paradoxical response from treatment failure. A 25-year-old woman was admitted for miliary lung nodules and multiple intracranial nodules. Antituberculous treatment was started with a preliminary diagnosis of tuberculosis based on the history and clinical findings. After one month, the miliary lung nodules improved while the intracranial nodules increased in size and number. Based on a stereotactic biopsy, it was confirmed that the intracranial lesions were tuberculomas. Although the therapeutic regimen was not changed, the symptoms eventually were ameliorated and the intracranial nodules improved two months later.
Adult ; Biopsy ; Female ; Humans ; Lung ; Treatment Failure ; Tuberculoma ; Tuberculoma, Intracranial ; Tuberculosis

Female ; Humans ; Middle Aged ; Sella Turcica ; Tuberculoma, Intracranial ; surgery

OBJECTIVE: Spinal intramedullary tuberculoma (SIMT) is rare, accounting for 2/100,000 cases of tuberculosis and only 0.2% of all cases of central nervous system(CNS) tuberculosis. We share our experiences of 11 cases of this entity for improving diagnosis and conceptualize the management of this rare disease. METHODS: The clinical profile, radiological data and management of 11 cases of SIMT which were managed either conservatively or by surgical intervention during last 27 years (1987-2014) were analysed. RESULTS: Male:female ratio was 1.75:1. Five cases had associated pulmonary Koch's. Most common site was thoracic cord. Two cases had concurrent multiple intracranial tuberculoma. Most common presentation was paraparesis. X-ray myelography was performed in two patients in the initial period of study suggesting intramedullary pathology. In the subsequent nine cases who had magnetic resonance imaging (MRI), seven showed typical "target sign" and conglomerate ring lesion. Out of 8 surgically managed patients, 6 cases improved rapidly and in 2 patients gradual improvement was seen in follow-up. Most common indication of surgical excision was rapid neurological deterioration followed by diagnosis in doubt. Histopathology confirmed tuberculous etiology of the intramedullary lesion in all. Clinical and radiological improvement was seen in all 3 conservatively managed patients in follow-up. CONCLUSION: MRI findings of SIMT were specific and proven histologically correct. Surgical intervention may be indicated if there is no response to chemotherapy, the diagnosis is in doubt, or there is a rapid deterioration in neurological function because surgical outcome is good in these circumstances.
Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Myelography ; Paraparesis ; Pathology ; Rare Diseases ; Tuberculoma* ; Tuberculoma, Intracranial ; Tuberculosis

The authors reviewed the medical records of 20 patients who were diagnosed as brain tuberculoma at Severance Hospital from 1980 to 1984. The 20 patients were presumptive cases based on clinical, roentgenological or laboratory findings without histologic proof were used, exept one. All cases were Korean, onset was between 3 to 59 years of age and there was no sexual preponderance. The initial clinical features were seizure, symptoms and signs of increased intracranial pressure, focal neurological signs, etc. Although a definite diagnosis is often not possible on CT scan, the method is of value in determining number, location and extent of lesions and in evaluating the effectiveness of antituberculous therapy. Fourteen of our 20 patients had single tuberculoma, six had mutliple or miliary tuberculoma and 18 cases were located on the cerebrum, two on the brainstem.
Brain Stem ; Brain* ; Cerebrum ; Diagnosis ; Humans ; Intracranial Pressure ; Medical Records ; Seizures ; Tomography, X-Ray Computed ; Tuberculoma*