Torres Martí A, Cano F, Castell J, Alvarez P, Gómez M J, Vivancos J, Balcells-Gorina A
Med Clin (Barc). 1980 Nov 10;75(8):346-9.
A case is reported of a 72 year-old female patient with multiple cerebral tuberculomas and a clinical course of 11 months that was characterized by personality changes, disorientation and progressive mental obtundation. The patient had a fatal outcome in spite of ventricular drainage and antituberculous therapy. Postmortem examination disclosed small tuberculomas in the cerebellum and brain stem, as well as residual tuberculous lesions in the upper lobe of the right lung. The clinical interest of this case lies in the old age of the patient, the rarity of the disease in western countries, and the location of tuberculomas in the brain stem with associated tuberculous meningitis. The higher incidence of cerebral tuberculomas in eastern and african countries is commented upon, and its anatomical, clinical, diagnostic and therapeutic features are reviewed. Finally, the two existing pathological forms and their respective clinical and therapeutic peculiarities are analyzed.
报告了一例72岁女性患者,患有多发性脑结核瘤,病程11个月,以人格改变、定向障碍和进行性精神迟钝为特征。尽管进行了脑室引流和抗结核治疗,患者仍死亡。尸检发现小脑和脑干有小结核瘤,以及右肺上叶有残留结核病变。该病例的临床意义在于患者年龄较大、西方国家该病罕见,以及脑干结核瘤伴结核性脑膜炎。文中提到了脑结核瘤在东方和非洲国家的较高发病率,并回顾了其解剖学、临床、诊断和治疗特征。最后,分析了两种现有的病理形式及其各自的临床和治疗特点。