title: Optochiasmatic tuberculoma as the sole manifestation of late recurrent tuberculosis.
abstract: Brain tuberculomas account for 10-20% of space occupying brain lesions in developing countries. Most lesions are observed at time of tuberculosis diagnosis or soon after starting treatment. We herein describe a 32 year-old patient with a 14-month history of headache and progressive visual loss. Her past medical history revealed pulmonary tuberculosis treated eight years before. A brain MRI showed a T1- and T2-weighted isointense contrast-enhancing lesion in the optic chiasm. A presumptive diagnosis of optochiasmatic tuberculoma was made and isoniazid, rifampin, pyrazinamide, and ethambutol were started. Despite treatment, the patient evolved to blindness. The prompt recognition of this condition is extremely important since the presence of optochiasmal enhancement is associated with blindness in patients with tuberculosis.
authors.affiliation: Tuberculosis Research Laboratory, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Brazil. marco.lima@ipec.fiocruz.br
authors.forename: Marco A
authors.initials: MA
authors.lastname: Lima
authors.forename: Antonio
authors.initials: A
authors.lastname: Aversa
authors.forename: Pericles
authors.initials: P
authors.lastname: Maranhão-Filho
authors.forename: Gabriela A
authors.initials: GA
authors.lastname: Lima
authors.forename: Andre
authors.initials: A
authors.lastname: Curi
authors.forename: Carolina A
authors.initials: CA
authors.lastname: Schmaltz
authors.forename: Flavia M
authors.initials: FM
authors.lastname: Santanna
mesh_terms: D000328:Adult; D001766:Blindness / Q000209:etiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009897:Optic Chiasm; D012008:Recurrence; D016862:Tuberculoma, Intracranial / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D014397:Tuberculosis, Pulmonary / Q000150:complications