Paradoxical Growth of Optochiasmatic Tuberculoma during the Treatment of Tuberculous Meningitis.
Intracranial brain parenchymal tuberculomas may form paradoxically, days to months after starting antituberculous drug therapy. They may develop in and around optic chiasm and optic nerves after antituberculous treatment as a quite rare occurrence in tuberculous meningitis (TBM) this may lead to severe visual loss if not treated properly. We describe a 5 year-old child with documented TBM being treated with first line antituberculous drugs which developed visual impairment 3 months after starting the treatment. MRI after gadolinium administration revealed multiple perichiasmatic ring enhancing lesions due to tuberculomas. Visual impairment developing in a patient on treatment with antituberculous drugs should give rise to a suspicion of rare optochiasmatic tuberculomas; this necessitates urgent contrast-enhanced MRI of the brain and prompt treatment with steroids.
Clinic of Radiology, UCCK, Prishtina, Kosova, Faculty of Medicine, Pristine University, Imaging Center Prima, Pristine, Kosova.
Ilir
I
Ahmetgjekaj
Clinic of Radiology, UCCK, Prishtina, Kosova, Faculty of Medicine, Pristine University, Imaging Center Prima, Pristine, Kosova.
Serbeze
S
Kabashi-Muçaj
University of Medicine and Pharmacy of Craiova, Romania.
Luana Corina
LC
Lascu
University of Medicine and Pharmacy of Craiova, Romania.
Simona
S
Bondari
University of Medicine and Pharmacy of Craiova, Romania.
A
A
Bondari
MRI; optochiasmatic tuberculoma; paradoxical response