Tubercular Lesions in Brain Parenchyma

Authors

  • Forhad Hossain Chowdhury Assistant Professor, Department of Neurosurgery, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh
  • Nur Mohammad Senior Consultant, Department of Radiology & Imaging, Comilla Medical College & Hospital, Comilla, Bangladesh
  • Mohammod Raziul Haque Associate Professor, Department of Neurosurgery, Dhaka Medical College, Dhaka, Bangladesh
  • Zahed Hossain Associate Professor, Department of Neurosurgery, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh
  • Md Abdus Salam Associate Professor, Department of Neurotrauma, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh
  • Mainul Haque Sarker Ex-Professor, Neurosurgery, Dhaka Medical College and Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.3329/bjid.v5i2.42151

Keywords:

Brain Parenchyma; tubercular lesion; cerebral tuberculoma; tubercular abscess

Abstract

Background: Preoperative neuro-radiological features of tuberculosis involving brain lesions may mimic neoplastic lesions of brain & skull base and post operative histopathological study or response to empirical anti-tubercular therapy brings the ultimate diagnosis.

Objective: Here we present our experience of 76 cases of cerebral and cerebellar tuberculosis that was managed surgically with anti-tubercular drugs or medical treatment alone without histopathological confirmation.

Methodology: All cases of brain parenchymal tuberculosis confirmed histopathologically after surgery or confirmed by succesfull conservative treatment with anti-TB from January 2008 to June 2015 were included for study. Tubercular meningitis was excluded from the study. Patients underwent some form of surgery that confirmed the tuberculosis by histopathologically. Patients with suspected tubercular lesion in brain were treated empirically with antiTB. Post operative imaging was done with CT scan of brain or MRI of brain in immediate post operative period, six months after operation and 18 months after operation.

Results: 34 patients underwent surgery to confirm the tuberculosis and 44 patients with suspected tubercular lesion in brain were treated empirically with antiTB of which 40 patients responded successfully and rest 4 patients did not responded and underwent surgical excisional biopsy. Common clinical features include features of raised ICP with focal signs and symptoms. Concurrent other systemic tuberculosis was found in three cases. One patient had history of full course anti-tubercular therapy for pulmonary tuberculosis 20 years back.

Conclusion: In suspected TB lesions, conservative treatment without histopathological diagnosis may be adopted with ultimate same result

Bangladesh Journal of Infectious Diseases, December 2018;5(2):45-60

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Published

2019-07-11

How to Cite

Chowdhury, F. H., Mohammad, N., Haque, M. R., Hossain, Z., Salam, M. A., & Sarker, M. H. (2019). Tubercular Lesions in Brain Parenchyma. Bangladesh Journal of Infectious Diseases, 5(2), 45–60. https://doi.org/10.3329/bjid.v5i2.42151

Issue

Vol. 5 No. 2 (2018)

Section

Original Articles

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Copyright on any research article in the Bangladesh Journal of Infectious Diseases is retained by the author(s).

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Articles in the Bangladesh Journal of Infectious Diseases are Open Access articles published under the Creative Commons CC BY-NC License (https://creativecommons.org/licenses/by-nc/4.0/)

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