BRAIN TUBERCULOMAS: A Series of 25 cases and review of the literature

Lakhdar F; Benzagmout M; Chakour K; Chaoui M F.

Volume : VIII, Issue : IX, September - 2019

BRAIN TUBERCULOMAS: A Series of 25 cases and review of the literature

Lakhdar F, Benzagmout M, Chakour K, Chaoui M F.

Abstract :

Background: Morocco is one of the countries that has high burden of all forms of tuberculosis. The occurrence of this condition, though previously reported only in the developing world. Commonly presented as tubercular meningitis, post–tubercular meningitis hydrocephalus, and much more rarely as space–occupying lesions known as tuberculomas. Cereal tuberculomas are a rare and serious form of tuberculosis (TB) due to the haematogenous spread of Mycobacterium Tuberculosis (MT). Objective : to review the clinical, epidemiological, computerized tomography and/or magnetic resonance imaging features, and treatment of intracranial tuberculoma. Methods: retrospective review of 25 patient�s medical records treated for ain tuberculomas that had computerized tomography and/or magnetic resonance imaging ain scans and confirmed histopathological diagnoses, at Hassan II Hospital between January 2008 and June 2018. Results: in 25 cases imaging was available for review and were included in the study . There were 15 males and 10 females with age range being 2 to 65 years and with the Median age being 13 years. Twenty patients had computerized tomography and five patients had magnetic resonance imaging. Seizure 15/25 (60%) and headache 11/25 (44%) were the commonest presentation. Solitary or confluent large lesions were seen in 12/25 (48%) of patients. 14/25 (56%) of the lesions had their size between 2 cm and 5 cm. Majority of the lesions 15/25 (60%) were in the frontal and parietal lobes. The lesions were isodense on CT in 18/25 (72%) of the pre–contrast studies and 21/25 (84%) showed ring or rim enhancement after intravenous administration of the contrast medium. Conclusion: Tuberculoma, more frequently, presented with non–specific clinical findings and chronic seizure disorder and commonly occurred in young patients and often seen infratentorialy. It is often complicated with hydrocephalus in the pediatric age group. Computerized tomography scan and/or magnetic resonance imaging features are not different from reports from other countries.