Aguirre A, Supervia A, Knobel H, Galofre N, Saballs P, Pascual J, Díez A
Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital del Mar, Barcelona.
An Med Interna. 1995 Oct;12(10):485-8.
Several problems are presented in differential diagnosis between cerebral tuberculomas and other brain lesions. Eight cases of cerebral tuberculomas diagnosed in our hospital between 1962 and 1992 were studied. Data about age, sex, HIV antibodies, clinical manifestation, tomographic images, non cerebral locations, diagnostic method, evolution and treatment resolution were collected. Eight cases were diagnosed, seven men and one woman, age 40.75 +/- 10 HIV antibodies in three patients were positive. Meningitis (4 cases) and weight loss (4 cases) were the first clinical features. Confusional state, fever and seizures were presented in three cases one (37.5%), ataxia in two cases (25%) and headache in one (12.5%). Lesions were sole in 62.5% of cases, and several in 37.5%. Were high density in 25.9% and low density in 75%. All patients presented a other localization of tuberculosis. Mycobacterium tuberculosis was isolated in sputum in 75% of cases. After six month, most of the lesions improved.
脑结核瘤与其他脑部病变的鉴别诊断存在几个问题。对我院1962年至1992年间诊断的8例脑结核瘤患者进行了研究。收集了有关年龄、性别、HIV抗体、临床表现、断层扫描图像、非脑部病变部位、诊断方法、病情演变及治疗结果的数据。8例患者被确诊,7例男性,1例女性,年龄40.75±10岁。3例患者HIV抗体呈阳性。脑膜炎(4例)和体重减轻(4例)是首发临床症状。3例(37.5%)出现意识模糊状态、发热和癫痫发作,2例(25%)出现共济失调,1例(12.5%)出现头痛。62.5%的病例病变为单发,37.5%为多发。25.9%为高密度病变,75%为低密度病变。所有患者均有其他部位的结核病灶。75%的病例痰中分离出结核分枝杆菌。6个月后,大多数病变有所改善。