[Suprasellar space-occupying lesion as initial manifestation of tuberculosis in childhood].
Three days after having sustained a mild trauma to the head a seven-year-old boy developed seizure-like rotatory vertigo. Computed tomography, magnetic resonance imaging and cerebral angiography demonstrated a suprasellar space-occupying lesion. Pulmonary tuberculosis was discovered in subsequent diagnostic work-up. Cerebrospinal fluid examination was unremarkable except for immunological tests (tuberculostearic acid) which pointed to central nervous system (CNS) involvement so that a tuberculoma was suspected. The lesion decreased in size on tuberculostatic treatment (200 mg/d isoniazid, 200 mg/d rifampicin, two times 250 mg/d pyrazinamide). In the next 12 months there merely persisted a mild abnormality of the blood-brain barrier with a little contrast-medium uptake, which regressed in the following 6 months. The differential diagnosis between CNS tuberculosis and brain tumour or pyogenic abscess can be difficult in children if there are no pulmonary signs and/or the cerebrospinal fluid is normal.
Abteilung Neuroradiologie, Kinderklinik der Technischen Hochschule Aachen.
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J
Reul
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V
Ramaekers
A
A
Thron
D000995:Antitubercular Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000175:diagnosis; D001932:Brain Neoplasms / Q000175:diagnosis; D002533:Cerebral Angiography; D002648:Child; D006259:Craniocerebral Trauma / Q000150:complications; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed; D016862:Tuberculoma, Intracranial / Q000150:complications / Q000175:diagnosis*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy; D014717:Vertigo / Q000209:etiology*
D000995:Antitubercular Agents
Supraselläre Raumforderung als Erstmanifestation einer Tuberkulose im Kindesalter.