title: A Clinical Study of Miliary Brain Tuberculomas in China.
abstract: Brain tuberculomas can exhibit many different clinical and radiological patterns. However, disseminated or miliary brain tuberculomas are very rare. Miliary brain tuberculomas have specific clinical prognostic implications. Seven patients diagnosed with miliary brain tuberculomas between December 2004 and August 2012 were evaluated retrospectively. Their clinical features, cranial magnetic resonance imaging (MRI) characteristics, treatments, and outcomes were reviewed. The median patient age was 42 years (range, 22-66 years). Six patients presented with fever, 5 with headache, 4 with papilledema, and 3 with diplopia. MRI studies revealed multiple brain lesions. MRI showed 20-50 lesions at the same level. These lesions measured approximately 2-4 mm in diameter and exhibited ring or nodular enhancement after gadolinium injection. All patients began to recover within 2 weeks of initiating antitubercular therapy (ATT). The number of lesions visible on MRI scans was halved within a month, and all lesions had healed without sequelae after 18 months of regular ATT. Miliary brain tuberculoma is a rare form of central nervous system tuberculosis. Some special characteristics of miliary brain tuberculomas are as follows: First, the presence of mild atypical clinical manifestations and almost normal laboratory findings; second, severe radiological features and 20-50 lesions at the same level on MRI scans; and third, a good response to standard ATT. Finally, they are benign; for instance, no patients died in our study. Early diagnosis and treatment can result in full recovery.
authors.affiliation: Dept of Neurology, Chinese People's Liberation Army General Hospital.
authors.forename: Ming
authors.initials: M
authors.lastname: Yang
authors.forename: Jia-Tang
authors.initials: JT
authors.lastname: Zhang
authors.forename: Yan
authors.initials: Y
authors.lastname: Yao
authors.forename: Qing-Che
authors.initials: QC
authors.lastname: Tan
authors.forename: Ting
authors.initials: T
authors.lastname: Gao
authors.forename: Cheng-Lin
authors.initials: CL
authors.lastname: Tian
authors.forename: Xusheng
authors.initials: X
authors.lastname: Huang
authors.forename: Sheng-Yuan
authors.initials: SY
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects* / Q000382:microbiology / Q000473:pathology; D003287:Contrast Media; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000627:therapeutic use; D005260:Female; D005682:Gadolinium; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000472:pathogenicity / Q000502:physiology; D011718:Pyrazinamide / Q000627:therapeutic use; D012293:Rifampin / Q000627:therapeutic use; D016896:Treatment Outcome; D016862:Tuberculoma, Intracranial / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology
chemical_list: D000995:Antitubercular Agents; D003287:Contrast Media; D011718:Pyrazinamide; D004977:Ethambutol; D005682:Gadolinium; D007538:Isoniazid; D012293:Rifampin; D008775:Methylprednisolone