Neurology and Therapeutics

Biography

Biography: Nicoleta Dumitrescu

Abstract

Worldwide are registered annually about 9 million cases of tuberculosis, Romania being the first in the EU, with an incidence of 87 cases /100.000 inhabitants (2013, World Health Organization). Aim: to report a very rare case of a 27 years-old man diagnosed with a cerebral intraventricular tuberculoma, after he had been treated two months for pulmonary tuberculosis with Mycobacterium tuberculosis - negative sputum smear. Case Report: The patient was brought on August 2015 to “Prof. dr. N. Oblu” Emergency Clinical Hospital, Iasi, by his family because of a confusional syndrome, somnolence and sphincter disorders. Cerebral magnetic resonance imaging showed asymmetrical hydrocephalus and a small homogenous enhanced lesion that was located in the lateral right cerebral ventricle and foramen of Monro. A surgical intervention by endoscopic approach was made. A white-yellowish, soft tumor located in the right lateral ventricle and extended into the third ventricle was seen. Cerebrospinal fluid (CSF) examination revealed leukocytes (8 cells/mm3) and intact red blood cells (340 cells/mm3). Histopathological examination of the biopsy showed rare Langhans giant cells, epithelioid histiocytes, and lymphocytes, but no caseous necrosis. A final diagnosis of an early intraventricular tuberculoma was established. The patient's evolution was favorable under the tuberculostatic treatment and corticoids. Conclusions: This case is customized by the acute development of the intraventricular tuberculoma (while the patient had already been treated with tuberculostatic therapy for two months for active pulmonary tuberculosis), low number of white blood cells in CSF, and negative bacterioscopic exam of sputum.