CHSJ

Curr Health Sci J, vol. 40, no. 3, 2014

Paradoxical Growth of Optochiasmatic Tuberculoma during the Treatment of Tuberculous Meningitis

[Case Reports]

I. AHMETGJEKAJ(1), S. KABASHI-MUQAJ(1), L. CORINA LASCU(2), S. BONDARI(2), A. BONDARI(2)


(1)Clinic of Radiology, UCCK, Prishtina, Kosova, Faculty of Medicine, Pristine University, Imaging Center Prima, Pristine, Kosova;
(2)University of Medicine and Pharmacy of Craiova, Romania


Abstract:

Intracranial brain parenchymal tuberculomas may form paradoxically, days to months after starting antituberculous drug therapy. They may develop in and around optic chiasm and optic nerves after antituberculous treatment as a quite rare occurrence in tuberculous meningitis (TBM) this may lead to severe visual loss if not treated properly. We describe a 5 year-old child with documented TBM being treated with first line antituberculous drugs which developed visual impairment 3 months after starting the treatment. MRI after gadolinium administration revealed multiple perichiasmatic ring enhancing lesions due to tuberculomas. Visual impairment developing in a patient on treatment with antituberculous drugs should give rise to a suspicion of rare optochiasmatic tuberculomas; this necessitates urgent contrast-enhanced MRI of the brain and prompt treatment with steroids.


Keywords: optochiasmatic tuberculoma, paradoxical response, MRI



Corresponding: Ilir Ahmetgjekaj, MD, Department of Radiology, UCCK, Prishtine, Kosova, President of the Radiolgist Asotiation of Kosova; e-mail: drilir@hotmail.com


DOI 10.12865/CHSJ.40.03.14 - Download PDF
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