Optochiasmatic tuberculoma as the sole manifestation of late recurrent tuberculosis

Revista do Instituto de Medicina Tropical de São Paulo

Marco A. Lima¹  Antonio Aversa¹  Pericles Maranhão-filho¹  Gabriela A. Lima¹  Andre Curi¹  Carolina A. Schmaltz²  Flavia M. Santanna² 

[1] ,Fundação Oswaldo Cruz Instituto de Pesquisa Clínica Evandro Chagas Tuberculosis Research Laboratory,Brazil

关键词: Tuberculosis;    Meningitis;    Optic chiasm;   

DOI  :  10.1590/S0036-46652012000400008

来源: SciELO

【 摘 要 】

Brain tuberculomas account for 10-20% of space occupying brain lesions in developing countries. Most lesions are observed at time of tuberculosis diagnosis or soon after starting treatment. We herein describe a 32 year-old patient with a 14-month history of headache and progressive visual loss. Her past medical history revealed pulmonary tuberculosis treated eight years before. A brain MRI showed a T1- and T2-weighted isointense contrast-enhancing lesion in the optic chiasm. A presumptive diagnosis of optochiasmatic tuberculoma was made and isoniazid, rifampin, pyrazinamide, and ethambutol were started. Despite treatment, the patient evolved to blindness. The prompt recognition of this condition is extremely important since the presence of optochiasmal enhancement is associated with blindness in patients with tuberculosis.

【 授权许可】

CC BY-NC   
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