Kosker Muhammet, Sener Dicle, Kilic Omer, Hasiloglu Zehra Isik, Islak Civan, Kafadar Ali, Batur Sebnem, Oz Buge, Cokugras Haluk, Akcakaya Necla, Camcioglu Yildiz
Division of Infectious Diseases, Clinical Immunology and Allergy, Department of Pediatrics, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
Division of Infectious Diseases, Clinical Immunology and Allergy, Department of Pediatrics, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
J Child Neurol. 2014 Dec;29(12):NP171-5. doi: 10.1177/0883073813509121. Epub 2013 Nov 27.
Primary diffuse leptomeningeal gliomatosis is a disease with an aggressive course that can result in death. To date, 82 cases have been reported. Here, the case of a 3-year-old male patient presenting with strabismus, headache, and restlessness is reported. Physical examination revealed paralysis of the left abducens nerve, neck stiffness, and bilateral papilledema. Tuberculous meningitis was tentatively diagnosed, and antituberculosis treatment was initiated when cranial imaging revealed contrast enhancement around the basal cistern. Craniocervical magnetic resonance imaging (MRI) was performed when there was no response to treatment, and it revealed diffuse leptomeningeal contrast enhancement around the basilar cistern, in the supratentorial and infratentorial compartments, and in the spinal region. Primary diffuse leptomeningeal gliomatosis was diagnosed by a meningeal biopsy.
原发性弥漫性软脑膜胶质瘤病是一种病程凶险、可导致死亡的疾病。迄今为止，已报告82例病例。在此，报告一例3岁男性患者，表现为斜视、头痛和烦躁不安。体格检查发现左侧展神经麻痹、颈部强直和双侧视乳头水肿。初步诊断为结核性脑膜炎，当头颅影像学显示基底池周围有强化时，开始抗结核治疗。治疗无反应时进行了颅颈磁共振成像（MRI），结果显示基底池周围、幕上和幕下腔室以及脊柱区域有弥漫性软脑膜强化。通过脑膜活检诊断为原发性弥漫性软脑膜胶质瘤病。
