An optochiasmatic tuberculoma, encasing the chiasm and optic nerves, was found in a 58-year-old woman complaining of sudden beginning and progressive visual failure. The patient was treated by surgery and prolonged corticosteroids and continued triple antituberculous therapy. Pathological diagnosis was a tuberculoma confirmed by postoperative positive polymerase chain reaction against M. tuberculosis. Because the incidence of tuberculomas has increased, especially in developing countries, in recent years and they also involve optic nerves and chiasm, it is important to include optochiasmatic tuberculoma in the differential diagnosis of optic nerve and chiasm tumors. Including this case, only 31 instances of optochiasmatic tuberculoma have been reported in the literature.
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Neuroophthalmology
November 2023
Department of Neurology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Tuberculosis (TB) is a global health concern and central nervous system (CNS) TB leads to high mortality and morbidity. CNS TB can manifest as tubercular meningitis, tuberculoma, myelitis, and arachnoiditis. Neuro-ophthalmological involvement by TB can lead to permanent blindness, ocular nerve palsies and gaze restriction.
View Article and Find Full Text PDFJ Glob Infect Dis
August 2023
Department of Neurology, King George's Medical University, Lucknow, Uttar Pradesh, India.
Tuberculous meningitis causes substantial morbidity and mortality in tropical countries. The various complications reported are hydrocephalus, vasculitic infarcts, tuberculomas, abscesses, and optochiasmatic arachnoiditis. Vasculitis in tuberculosis is basically at the level of lenticulostriate arteries supplying the basal ganglia and terminal cortical branches.
View Article and Find Full Text PDFJ Neuroophthalmol
December 2024
Neuro-Ophthalmology Division (WB, HS), Service of Ophthalmology, Department of Clinical Neuroscience, Geneva University Hospitals, Geneva, Switzerland ; Neuroradiology Division (MIV), Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland; Pneumology Division (GK, J-PJ), Geneva University Hospitals, Geneva, Switzerland; Department of Neurosurgery (MVC), Geneva University Hospitals, Geneva, Switzerland; Neurosurgery Division (MVC), Department of Neuroscience, Rennes University Hospitals, Rennes, France; Laboratoire de traitement de signal (MVC), Groupe Medicis, INSERM UMR 1099, University of Rennes I, Rennes, France; Neurology Division (CB), Department of Clinical Neuroscience, Geneva University Hospitals, Geneva, Switzerland; and Department of Neurosurgery (TRM), The National Hospital of Denmark, Copenhagen, Denmark.
Clin Infect Dis
November 2023
Department of Infectious Diseases, Christian Medical College, Vellore, Tamil Nadu, India.
Background: Few treatment options exist for patients with severe central nervous system (CNS) tuberculosis (TB) worsening due to inflammatory lesions, despite optimal antitubercular therapy (ATT) and steroids. Data regarding the efficacy and safety of infliximab in these patients are sparse.
Methods: We performed a matched retrospective cohort study based on Medical Research Council (MRC) grading system and modified Rankin Scale (mRS) scores comparing 2 groups of adults with CNS TB.
Acta Neurol Belg
February 2021
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
Tuberculous (TB) meningitis (TBM), accounting for 70-80% of cases of neurotuberculosis, is one of the most severe forms of extrapulmonary tuberculosis. Two-thirds of new TB cases come from eight countries. Polymorphisms in toll-interleukin-1 receptor domain and in leukotriene A4 hydrolase (LTA4H) gene, affect the risk of inflammation in TBM.
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