Case Report

Brain Tuberculomas Due to Miliary Tuberculosis

Authors: Nikolaos Akritidis, MD, Eftichia Galiatsou, MD, PHD, John Kakadellis, MD, Konstantinos Dimas, MD, Konstantinos Paparounas, MD, PHD

Abstract

Brain tuberculomas are a rare complication of tuberculosis arising through hematogenous spread from an extracranial source, most often of pulmonary origin. The clinical course is usually subacute or chronic, lasting weeks or months, and they typically occur in immunocompromised patients. Recognition and prompt diagnosis of this disorder is important because early treatment can prevent patient worsening and lead to clinical improvement. The authors report a 68-year-old diabetic man with headache and cognitive/behavioral changes in whom investigation revealed disseminated brain tuberculomas resulting from miliary tuberculosis. He received anti-tuberculous treatment and had an excellent recovery.


Key Points


* Brain tuberculomas are a rare, insidious complication of tuberculosis and occur as a result of hematogeneous spread from a primary focus, usually the lung.


* Brain tuberculomas usually occur in immunocompromised patients and may appear with nonspecific neurologic symptoms or can cause focal signs and cognitive and behavioral changes.


* Brain tuberculomas are presented as one or more parenchymal granulomas, and magnetic resonance imaging of the brain is highly helpful for their diagnosis and follow-up.

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