多発性脳結核腫の1例

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A case of multiple cerebral tuberculomas associated with tuberculous brain abscess is presented. The characteristics of computed tomography (CT) appearance, diagnosis, pathology and treat-ment of cerebral tuberculoma are discussed. The patient, a 67-year-old female, was initially admitted to a sanatorium for the treatment of lung tuberculosis. She developed headache and nausea with mental confusion. She was then transferred in November 1982. A neurological examination showed that she was in a confused state, and that she had dysarthria, papilledema, neck stiffness and left hemiparesis. Enhanced CT scans showed multiple lesions, some of which were homogeneously enhanced and others were ring-like enhanced. A right occipital craniotomy was performed and a mass was excised en bloc. The mass con-tained purulent material. Acid-fast bacillus stain of the pus was positive and histological examina-tion of the capsule wall demonstrated tuberculoma. Three weeks later, a right temporal craniotomy was performed, because the right temporal lesion grew rapidly. The same histological findings were obtained. Antituberculous chemotherapy was continued. One month later, the homogeneously enhanced lesions almost disappeared. However, the ring-like enhanced lesions kept growing to become multiple large masses. In January 1984, the patient remained stuporous.
日本脳神経外科学会の論文
1984-12-15