Paradoxical intracranial tuberculoma requiring surgical treatment.
Paradoxical enlargement of intracranial tuberculomas or development of new ones during adequate antituberculous chemotherapy is an uncommon event. Treatment of such cases is controversial. Steroid therapy is usually advocated without change in the antituberculous drug program. However, in some patients whose lesions fail medical treatment, or who have superficially located large lesions, surgical therapy may be required. A 15-year-old girl with pulmonary miliary tuberculosis, tuberculous meningitis and multiple intracranial tuberculomas is presented. While her pulmonary lesions and intracranial tuberculomas except one were healed with chemotherapy, one tuberculoma increased in size 1 month after starting chemotherapy. She was followed with dexamethasone treatment in addition to antituberculous therapy for 2 months. Then, the lesion was removed because it had increased in size in spite of appropriate chemotherapy.
Bas
N Serdar
NS
Department of Neurosurgery, SSK Vakif Gureba Training Hospital, Istanbul, Turkey.
Güzey
Feyza Karagöz
FK
Emel
Erhan
E
Alatas
Ibrahim
I
Sel
Baris
B
D000293:Adolescent; D000995:Antitubercular Agents / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005625:Frontal Lobe / Q000473:pathology / Q000601:surgery*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D017211:Treatment Failure; D016862:Tuberculoma, Intracranial / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*
D000995:Antitubercular Agents; D005938:Glucocorticoids; D003907:Dexamethasone