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[一例脑结核瘤(作者译)]

[A case of cerebral tuberculoma (author's transl)].

作者信息

Shinmura F, Sakakibara T, Takayasu K, Takagi S, Satowa S

出版信息

No Shinkei Geka. 1979 Feb;7(2):191-5.

PMID:106318
Abstract

A 27-year-old woman was admitted to other hospital for acute pleuritis in May 1977. She suddenly had a focal epileptic seizure in the face with loss of consciousness on July 10, 1977. The same episodes of seizure occurred on Aug. 8, on Oct. 26, on Nov. 22, 1977. She was admitted to our hospital on Dec. 12, 1977. Neurological examinations showed no abnormality. Chest X-ray film showed bilateral severe thickening of the pleura. Plain skull films showed normal findings. Enhanced CT scanning showed a homogenous irregular contour of high density area surrounded by low density area in the right frontal region. The lateral ventricle was slightly shifted to the left side. 99mTc brain scan also detected a spherical abnormal uptake in this area. Right carotid angiography showed no abnormal vessels and increased vascularities. On Nov. 22, 1977, a craniotomy was made over the right fronto-temporal bone, and a walnut sized tumor in the frontal subcortex was totally removed successfully. Histologically, the tumor was diagnosed as brain tuberculoma. The antituberculous therapy (AB-PC, INAH, Rifampicin), high doses of gammabenin, and steroid were given. About four months later, she was in good health without neurologic deficits and returned to her work. The literature was reviewed, and the value of CT scan and RI scan in the diagnosis of cerebral tuberculoma was emphasized.

摘要

一名27岁女性于1977年5月因急性胸膜炎入住其他医院。1977年7月10日,她突然面部出现局灶性癫痫发作并伴有意识丧失。1977年8月8日、10月26日、11月22日又发生了同样的癫痫发作。1977年12月12日她入住我院。神经系统检查未发现异常。胸部X线片显示双侧胸膜严重增厚。头颅平片显示正常。增强CT扫描显示右侧额叶区域有一个高密度区,其轮廓不规则,周围为低密度区,侧脑室轻度向左移位。99mTc脑扫描也在该区域检测到一个球形异常摄取。右侧颈动脉血管造影未显示异常血管及血管增多。1977年11月22日,在右侧额颞骨进行开颅手术,成功地完全切除了额叶皮质下一个核桃大小的肿瘤。组织学检查诊断该肿瘤为脑结核瘤。给予抗结核治疗(AB - PC、异烟肼、利福平)、大剂量γ球蛋白及类固醇。约四个月后,她身体健康,无神经功能缺损,恢复工作。本文回顾了文献,并强调了CT扫描和RI扫描在脑结核瘤诊断中的价值。

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