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A case of intracerebral tuberculoma resistant to therapy Manabu SASAKI 1 , Masaharu SATO 1 , Junji TAGUCHI 1 , Sonoko NOZAKI 2 , Jin KANG 2 , Toshihiko YAMAGUCHI 3 , Shigeharu TANAKA 3 , Toru HAYAKAWA 4 1Department of Neurosurgery, Toyonaka Municipal Hospital 2Department of Neurology, Toneyama National Hospital 3Department of Internal Medicine, Toneyama National Hospital 4Department of Neurosurgery, Osaka University Medical School Keyword: brain tumor , Mycobacterium tuberculosis , PCR , tuberculoma , tuberculosis pp.835-839
Published Date 1996/9/10
DOI https://doi.org/10.11477/mf.1436901271
  • Abstract
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A 48-year-old woman complained of fever, headache and nausea in October, 1994. Because polymerase chain reaction (PCR) was positive for mycobacterium tuber-culosis in her cerebrospinal fluid, she was administered anti-tuberculous drugs. Steroid hormone was also admi-nistered for her symptoms of intracranial hypertension. However, multiple intracerebral masses appeared on CT and MRI 2 months later, and have increased in number and size. Cessation of the steroid homone was impossible as her intracranial hypertension had been deteriorated. She was transferred to our clinic on Octo-ber 23, 1995. On neurological examination she was drowsy and showed papilledema, weakness of bilateral lower extre-mities, left cerebellar sign, and bilateral Babinski's re-flexes. Enhanced CT and MRI revealed multi-locular le-sions in the right fronto-temporal, left temporal and left cerebellar regions. On November 7,1995 she was oper-ated on. Right fronto-temporal and left cerebellar mas-ses were partially removed. Pathological examination and PCR of the surgical specimens demonstrated tuber-culoma.

Postoperatively, her consciousness disturbance im-proved and the residual tuberculomas decreased in size under the influence of anti-tuberculous drugs and cessa-tion of the use of steroid hormone. Recently, tuberculosis is common neither in Japan nor in Western countries. Intracerebral tuberculoma is also very rare. The tuberculosis in our patient with multiple intracerebral tuberculomas resistant to anti-tuberculous drugs was thought to have been induced by decreased resistance to the infection due to the administration of the steroid hormone.


Copyright © 1996, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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