Tuberculous brainstem abscess: case report.
OBJECTIVE
Tuberculous brainstem abscess is a clinically rare condition with potentially high mortality and morbidity. We present this report to draw attention to the importance of early recognition and adequate treatment of tuberculous brainstem abscess.


METHODS
A 24-year-old man complained of longstanding fever, headache, and weakness followed by development of progressive slurred speech and hemiparesis of the right extremities. Magnetic resonance imaging revealed a large thick-walled cystic lesion lying within the brainstem.


METHODS
The patient demonstrated a remarkable clinical recovery after microsurgery combined with a course of antituberculous therapy. Microbiological and histological findings confirmed the diagnosis of a tuberculous abscess.


CONCLUSIONS
Despite its rarity, the tuberculous brainstem abscess must be considered in the differential diagnosis of cystic brainstem mass lesions in vulnerable patients. When confronted with progressing neurological deterioration and poor response to antituberculous therapy, stereotactic or microsurgical management should be considered. Microsurgical excision combined with a complete course of antituberculous therapy in our patient led to a good outcome.
Jiang
Yu-Gang
YG
Department of Neurosurgery, Second Xiangya Hospital of Central South University, Changsha, People's Republic of China. 13707315567@139.com
Chen
Jing
J
Peng
Yong
Y
D001922:Brain Abscess / Q000150:complications / Q000473:pathology* / Q000601:surgery; D001933:Brain Stem / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008866:Microsurgery / Q000379:methods; D020306:Tuberculosis, Central Nervous System / Q000150:complications / Q000601:surgery; D055815:Young Adult