Lu Zhengqi, Zhang Bingjun, Qiu Wei, Hu Xueqiang
Multiple Sclerosis Centre, Department of Neurology, the Third Affiliated Hospital of Sun Yat-sen University, China.
Intern Med. 2011;50(18):2031-4. doi: 10.2169/internalmedicine.50.5518. Epub 2011 Sep 15.
Intracranial tuberculoma and neurocysticercosis (NCC) are the most frequent granulomatous infections in the central nervous system. Here we report a 41-year-old man with disseminated intracranial tuberculoma mimicking NCC. The patient complained of relapsing vertigo and vomiting consistent with Bruns syndrome. Serum antibodies against cysticercosis were positive. Magnetic resonance imaging (MRI) of the brain showed multiple disseminated ring-enhanced lesions. An initial diagnosis of NCC was made based on clinical signs and MRI. However, during antiparasitic treatment, the patient exhibited fever, meningitis signs, and positive cerebrospinal fluid findings for tuberculosis. The diagnosis was therefore corrected as tuberculoma. After three months of antituberculous treatment, the patient recovered clinically and on MRI. Our results highlight the importance of differential diagnosis of these two diseases in the early stage.
颅内结核瘤和神经囊尾蚴病（NCC）是中枢神经系统最常见的肉芽肿性感染。在此，我们报告一名41岁男性，其播散性颅内结核瘤酷似NCC。患者主诉反复出现与布伦斯综合征相符的眩晕和呕吐。囊尾蚴病血清抗体呈阳性。脑部磁共振成像（MRI）显示多个播散性环形强化病灶。基于临床症状和MRI初步诊断为NCC。然而，在抗寄生虫治疗期间，患者出现发热、脑膜炎体征，脑脊液结核检查结果呈阳性。因此，诊断修正为结核瘤。经过三个月的抗结核治疗，患者临床症状恢复，MRI检查结果也恢复正常。我们的结果凸显了早期鉴别诊断这两种疾病的重要性。
