What is central nervous system tuberculoma?

summary

What is central nervous system tuberculoma? Tuberculoma of central nervous system is a space occupying lesion of brain or spinal cord parenchyma, most of which are brain tuberculoma. Brain tuberculoma is a caseous granuloma lesion composed of epithelioid cells and macrophages containing tuberculosis bacteria in the brain, which can form calcification, extensive caseous necrosis and occasionally cold abscess.

What is central nervous system tuberculoma?

Tuberculoma of central nervous system is a space occupying lesion of brain or spinal cord parenchyma, most of which are brain tuberculoma. Brain tuberculoma is a caseous granuloma lesion composed of epithelioid cells and macrophages containing tuberculosis bacteria in the brain, which can form calcification, extensive caseous necrosis and occasionally cold abscess. Tuberculoma is neither a complication of stable tuberculous meningitis nor an incurable late lesion. Only less than 10% of tuberculomas are complicated with tuberculous meningitis. In the high incidence and epidemic areas of tuberculoma, a few patients are asymptomatic, and calcified granuloma is often accidentally found during brain scan. Tuberculoma is more common in adults than in children. Most of the patients present brain tumor like manifestations, For example, headache that gradually worsens for several weeks or months, accompanied by epileptiform seizures and abnormal local brain damage, and then the space occupying effect gradually becomes obvious, and the brain function gradually declines. Neurological examination can find papilledema, abducens nerve paralysis, hemiplegia, visual field defect, multiple muscle spasm, hemiparkinsonism, etc.

Enhanced CT is the most valuable in the diagnosis of tuberculoma. CT shows that tuberculoma varies in size and number. Most of them are single lesions, which can occur in any part of the brain. Most of them are distributed in the cerebral hemisphere, basal ganglia and brainstem. Children's infratentorial tumor is more common than adults. The tumor has calcified edge. Enhanced scan shows enhanced imaging around the lesion. Cerebrospinal fluid examination is usually normal.

The gold standard for the diagnosis of central tuberculoma is histological examination, which is characterized by caseous necrosis of tuberculous granulation tissue. Most of the tuberculous foci are fused. Anti tuberculosis drug therapy is the main treatment. Surgical resection is feasible for single tuberculoma.

matters needing attention

Tuberculoma of central nervous system is a space occupying lesion of brain or spinal cord parenchyma, most of which are brain tuberculoma. Brain tuberculoma is a caseous granuloma lesion composed of epithelioid cells and macrophages containing tuberculosis bacteria in the brain, which can form calcification, extensive caseous necrosis and occasionally cold abscess. Tuberculoma is neither a complication of stable tuberculous meningitis nor an incurable late lesion. Only less than 10% of tuberculoma patients have tuberculous meningitis.