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Tuberculoma in childrens

Ira Shah, Naman S Shetty
The usual treatment duration of tuberculomas recommended is 1 year. While anti-tuberculous therapy is of absolute necessity for the treatment of central nervous system tuberculosis, no clear guidelines exist regarding the duration of therapy in case of persistent tuberculomas. We present a series of six cases of children with central nervous system tuberculosis who received anti-tuberculous therapy for a period varying between 23 and 32 months depending on the resolution of lesion seen in neuroradiological scans of the patients...
2019: SAGE Open Medical Case Reports
Shailendra Ratre, Sushma Choudhary, Yadram Yadav, Vijay Parihar, Jitin Bajaj, Anurag Pateriya
Tuberculosis of the central nervous system (CNS) is well known. CNS involvement can occur in the form of tubercular meningitis (TBM), tuberculous vasculitis, tuberculoma and rarely brain abscess. Tubercular granulomas generally solitary and occur in the brain but they may be multiple and involve other areas such as spinal cord, epidural space and subdural space also. Tuberculoma in the spinal cord is rare. Co-occurrence of intracerebral and intramedullary spinal tuberculoma is extremely rare in children with only few cases reported till date...
April 2018: Journal of the Association of Physicians of India
Mónica Ramírez, Eduardo Cortés, José Betancur, Carlos Garcés
Cerebral tuberculosis TB (tuberculomas) without meningitis is an uncommon disease with a high morbidity and mortality. We report on a case that illustrates the complexity of this clinical presentation. An 11 month old, previously healthy male infant was brought to the clinic due to fever present during the last 1.5 months, associated with loss of neurodevelopmental goals and signs of endocranial hypertension. CT scan of the skull revealed dilatation of the ventricular system with transependimary edema; MRI showed multiple intra- and extra-axial micronodular images and hydrocephalus...
April 2018: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Pravin Tukaram Survashe, Sachin Guthe, Vernon Velho, Harish Naik
Introduction: Parinaud's Syndrome is an inability to move the eyes upwards which is caused by damage to the tectal plate of midbrain. Commonest causes implicated are the Pineal tumors in children, Multiple Sclerosis in adults and stroke in elderly patients. We present a rare case of Tectal plate tuberculoma leading to Parinaud's Syndrome. Discussion: Parinaud's syndrome is caused by damage to the tectal plate or posterior commissure of midbrain. Our patient presented with upward gaze paresis and was diagnosed to have tuberculoma involving the midbrain region...
April 2018: Asian Journal of Neurosurgery
Tinsae Alemayehu, Wondwossen Ergete, Workeabeba Abebe
Background: Pediatric nervous system tuberculomas are usually infra-tentorial and multiple. A frontal lobe location is rare. Case Details: We report a 10 year-old boy who presented with a chronic headache and episodes of loss of consciousness. He had no signs of primary pulmonary tuberculosis and a diagnosis of frontal tuberculoma was made upon a post-operative biopsy. He improved following treatment with anti-tubercular drugs. Conclusion: Tuberculosis should be considered in children with a chronic headache or focal neurologic deficit and a supra-tentorial intracranial mass in endemic countries like Ethiopia...
November 2017: Ethiopian Journal of Health Sciences
Mukti Sharma, Arvind Gupta, Amarjit Singh
No abstract text is available yet for this article.
April 1995: Medical Journal, Armed Forces India
M Kanitkar, S B Purkayastha, N D Deshpande
50 consecutive cases of partial seizures hospitalised over a period of 2 years, were studied. CT Scans were done once at presentation and thereafter cases were followed up with repeat CT scans to evaluate treatment response wherever a treatable cause was found. CT scan diagnosis was correlated with clinical signs and other baseline investigations including an EEG. CT scan abnormality was detected in 66% cases. Single or multiple tuberculomas were noted in 24% cases, cortical atrophy in 14% cases, focal calcification in 10%, haemorrhage in 3% and subdural effusions in 2%...
January 1994: Medical Journal, Armed Forces India
Sukhdeep Singh Jhawar, Garewal Singh Sarvpreet, T N Shadangi
Exophytic pontine glioblastoma multiforme (GBM) is a highly malignant tumor of posterior fossa, which is quite rare and such tumor presenting as cerebellopontine (CP) angle mass is even rarer. Here, we describe a 12-year-old boy who presented with imbalance on walking and facial nerve paresis. Magnetic resonance imaging of the brain revealed an irregular ring enhancing mass lesion of the CP angle, which was initially thought to be a tuberculoma, but was later confirmed to be a GBM. Clinical and radiological differentiation of uncommon lesions of CP angle in children is discussed with brief review of pertaining literature...
April 2017: Asian Journal of Neurosurgery
Abdelmoneim E M Kheir, Salah A Ibrahim, Ahlam A Hamed, Badreldin M Yousif, Farouk A Hamid
BACKGROUND: Tuberculosis remains a public health problem in developing countries and is associated with lethal central nervous system complications. Intracranial tuberculomas occur in 13% of children with neurotuberculosis. Patients with trisomy 21 have an increased risk for stroke, which usually stems from cardiovascular defects. CASE PRESENTATION: We report a case of a 12-year-old Sudanese boy with trisomy 21 who was presented to our hospital with focal convulsions and right-sided weakness...
April 18, 2017: Journal of Medical Case Reports
Elizabeth W Tucker, Supriya Pokkali, Zhi Zhang, Vincent P DeMarco, Mariah Klunk, Elizabeth S Smith, Alvaro A Ordonez, Marie-France Penet, Zaver Bhujwalla, Sanjay K Jain, Sujatha Kannan
Central nervous system (CNS) tuberculosis (TB) is the most severe form of extra-pulmonary TB and disproportionately affects young children where the developing brain has a unique host response. New Zealand white rabbits were infected with Mycobacterium tuberculosis via subarachnoid inoculation at postnatal day 4-8 and evaluated until 4-6 weeks post-infection. Control and infected rabbit kits were assessed for the development of neurological deficits, bacterial burden, and postmortem microbiologic and pathologic changes...
December 1, 2016: Disease Models & Mechanisms
Ira Shah, M V Bhaskar
We sought to determine the incidence and clinical spectrum of the paradoxical reaction (PR) to treatment in 1000 children with tuberculosis (TB). Its incidence was 3.3%, presenting as mediastinal adenopathy (n = 12), central nervous system (CNS) tuberculoma (n = 8), increasing size of lymph nodes (n = 8) and serositis (n = 5). Symptoms included breathlessness (n = 7, 21.2%), neck swellings (n = 5, 15.2%), hemiplegia (n = 3, 9.1%), raised intracranial tension (n = 2, 6.1%) and fever or diabetes insipidus (n = 1, 3% each)...
April 2017: Tropical Doctor
Nguyen T H Mai, Guy E Thwaites
PURPOSE OF REVIEW: Tuberculous meningitis is a devastating infection that is hard to diagnose and treat. We have reviewed tuberculous meningitis original research published within the past 18 months, selecting studies which we consider have most advanced knowledge. RECENT FINDINGS: We review advances in diagnostic methods, anti-tuberculosis chemotherapy, and the common complications of tuberculous meningitis. New commercial molecular diagnostic tests, such as GeneXpert MTB/RIF, have an important role in tuberculous meningitis diagnosis, but as with all other available tests, they lack sensitivity and cannot rule out the disease...
February 2017: Current Opinion in Infectious Diseases
Isabelle Viel-Thériault, Roseline Thibeault, Francois D Boucher, Jean-Philippe Drolet
Paradoxical immune reconstitution inflammatory syndrome is a well-described entity even in immunocompetent children, principally in association with Mycobacterium tuberculosis infections. Central nervous system involvement is a potential life-threatening form, sometimes refractory to standard treatment. We report the case of an HIV-negative refugee teenager, who presented with brain tuberculomas and pseudoabscesses responsive only to thalidomide.
November 2016: Pediatric Infectious Disease Journal
Isabelle Viel-Thériault, Roseline Thibeault, Francois D Boucher, Jean-Philippe Drolet
Paradoxical immune reconstitution inflammatory syndrome (IRIS) is a well described entity even in immunocompetent children, principally in association with Mycobacterium tuberculosis infections. Central nervous system involvement is a potential life-threatening form, sometimes refractory to standard treatment. We report the case of an HIV-negative refugee teenager, who presented with brain tuberculomas and pseudo-abscesses responsive only to thalidomide.
June 21, 2016: Pediatric Infectious Disease Journal
Ursula K Rohlwink, Tracy Kilborn, Nicky Wieselthaler, Ebrahim Banderker, Eugene Zwane, Anthony A Figaji
BACKGROUND: Pediatric tuberculous meningitis (TBM) leads to high rates of mortality and morbidity. Prompt diagnosis and initiation of treatment are challenging; imaging findings play a key role in establishing the presumptive diagnosis. General brain imaging findings are well reported; however, specific data on cerebral vascular and spinal involvement in children are sparse. METHODS: This prospective cohort study examined admission and followed up computed tomography brain scans and magnetic resonance imaging scans of the brain, cerebral vessels (magnetic resonance angiogram) and spine at 3 weeks in children treated for TBM with hydrocephalus (HCP; inclusion criteria)...
October 2016: Pediatric Infectious Disease Journal
Kamini Gupta, Avik Banerjee, Kavita Saggar, Archana Ahluwalia, Karan Saggar
BACKGROUND: Infections of the central nervous system (CNS) are common and routinely encountered. Our aim was to evaluate the neuroimaging features of the various infections of the CNS so as to differentiate them from tumoral, vascular, and other entities that warrant a different line of therapy. AIMS: Our aim was to analyze the biochemical and magnetic resonance imaging (MRI) features in CNS infections. SETTINGS AND DESIGN: This was a longitudinal, prospective study over a period of 1½ years...
January 2016: Journal of Pediatric Neurosciences
V Nancy Jeniffer, S Udayakumar, K Pushpalatha
CONTEXT: Epilepsy is one of the common neurological disorders worldwide. Fundamentally, there are two types of epilepsy-primary generalized epilepsy and localization-related epilepsy. Partial seizures account for about 40% of childhood seizures in some series and can be classified as simple or complex.[1] Partial seizures, more so the complex partial seizures (CPSs), are presumed to have a structural etiology. AIMS: (1) To study the magnetic resonance imaging (MRI) brain findings in CPSs in children aged 1-18 years...
October 2015: Journal of Pediatric Neurosciences
Noella Maria Delia Pereira, Ira Shah, Naresh Biyani, Forum Shah
Tuberculomas are usually infratentorial in children, and supratentorial lesions predominate in adults. We present a 4-year-old girl with multiple seizures, papilloedema and brisk reflexes. On investigation, she was found to have a large left parafalcine tuberculoma. She was treated with antitubercular treatment (ATT) and steroids. The child improved, seizures stopped and the papilloedema gradually disappeared. Follow-up magnetic resonance imaging brain after 8 months showed a mild reduction in the size of the lesion...
January 2016: Oxford Medical Case Reports
Griselda Escobedo-Meléndez, Leopoldo Portillo-Gómez, Miguel A Andrade-Ramos, David Bocanegra, Rodrigo Mercado-Pimentel, Luis Arredondo, Dara Torres, Miguela A Caniza
BACKGROUND: Tuberculosis is a major health concern in Mexico, especially among the native population. Tuberculomas are a frequent and severe complication of pediatric tuberculosis, these are observed as tumors in neuroimaging studies but are often not diagnosed adequately. CASE PRESENTATION: We present a case of a 12-year-old native Mexican girl Huichol ethnicity diagnosed with a large posterior fossa tuberculoma found by imaging. This tuberculoma was surgically removed...
2014: BMC Research Notes
Gilad D Birnbaum, Lucila Marquez, Kevin M Hwang, Andrea T Cruz
Clinical deterioration while receiving antituberculosis (anti-TB) therapy can be due to a number of etiologies, including drug resistance, disease progression despite effective therapy, or alternative diagnoses. We present the case of a 22-month-old girl diagnosed with TB meningitis 4 months prior to presentation. At time of her initial diagnosis, computed tomography showed hydrocephalus and basilar meningitis with some evidence of ischemic damage. She required placement of a ventriculoperitoneal shunt and was discharged on multidrug anti-TB therapy and corticosteroids...
August 2014: Pediatric Emergency Care
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