[en] Three days after having sustained a mild trauma to the head a seven-year-old boy developed seizure-like rotatory vertigo. Computed tomography, magnetic resonance imaging and cerebral angiography demonstrated a suprasellar space-occupying lesion. Pulmonary tuberculosis was discovered in subsequent diagnostic work-up. Cerebrospinal fluid examination was unremarkable except for immunological tests (tuberculostearic acid) which pointed to central nervous system (CNS) involvement so that a tuberculoma was suspected. The lesion decreased in size on tuberculostatic treatment (200 mg/d isoniazid, 200 mg/d rifampicin, two times 250 mg/d pyrazinamide). In the next 12 months there merely persisted a mild abnormality of the blood-brain barrier with a little contrast-medium uptake, which regressed in the following 6 months. The differential diagnosis between CNS tuberculosis and brain tumour or pyogenic abscess can be difficult in children if there are no pulmonary signs and/or the cerebrospinal fluid is normal.
Disciplines :
Pediatrics Neurology
Author, co-author :
Reul, J.; Abteilung Neuroradiologie, Zentrum für Radiologische Diagnostik, und Bereich Neuropädiatrie, Kinderklinik der Technischen Hochschule Aachen
RAMAEKERS, Vincent ; Neuropädiatrie, Kinderklinik der Technischen Hochschule Aachen
Thron, A.; Abteilung Neuroradiologie, Zentrum für Radiologische Diagnostik, und Bereich Neuropädiatrie, Kinderklinik der Technischen Hochschule Aachen
Language :
English
Title :
Suprasellare Raumforderung als Erstmanifestation einer Tuberkulose im Kindesalter.
Alternative titles :
[en] Suprasellar space-occupying lesion as initial manifestation of tuberculosis in childhood
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