Development of tuberculoma during therapy presenting as hemianopsia

Ming Han Tsai, Yhu Chering Huang, Tzou Yien Lin

Research output: Contribution to journalArticle

9 Citations (Scopus)

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 Steroids were instituted on day 16 and gradually withdrawn 1 month later.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.

Original languageEnglish
Pages (from-to)360-363
Number of pages4
JournalPediatric Neurology
Volume31
Issue number5
DOIs
Publication statusPublished - Nov 2004
Externally publishedYes

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience
  • Neurology

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