Development of tuberculoma during therapy presenting as hemianopsia.

Abstract:

:A 6-year-old, previously healthy male presented with fever and lethargy. Tuberculous meningitis was suspected after cerebrospinal fluid examination. Antituberculous drugs were administered, and an initial computed tomographic scan of brain revealed mild ventriculomegaly only. Steroids were instituted on day 16 and gradually withdrawn 1 month later. Nine weeks after the initiation of antituberculous therapy, markedly impaired visual acuity and bitemporal hemianopsia were observed. Magnetic resonance imaging of brain revealed multiple tuberculomas, including involvement of the optic chiasm. Hydrocephalus was present. A ventriculoperitoneal shunt was inserted, and steroids were reinstituted. Visual acuity improved 9 weeks after the onset of visual acuity impairment and returned to normal 24 weeks later.Follow-up computed tomographic scan of brain 1 year later demonstrated complete resolution of tuberculomas. Development of intracranial tuberculoma during antituberculous therapy, although rare, dose not represent treatment failure, and continuation of antituberculous drugs, with or without the addition of steroids, will usually resolve the lesions.

journal_name

Pediatr Neurol

journal_title

Pediatric neurology

authors

Tsai MH,Huang YC,Lin TY

doi

10.1016/j.pediatrneurol.2004.05.008

subject

Has Abstract

pub_date

2004-11-01 00:00:00

pages

360-3

issue

5

eissn

0887-8994

issn

1873-5150

pii

S0887-8994(04)00284-X

journal_volume

31

pub_type

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