Tuberculomas cerebrais múltiplos em lactente

[Multiple cerebral tuberculomas: report of an autopsy case with 37 lesions]

An autopsied case of multiple cerebral tuberculomas with 37 lesions, the one with the greatest number of lesions described in the literature, is reported. The patient was a chronic alcoholic and had generalized tuberculosis. The literature on multiple cerebral tuberculomas is reviewed and the neurological clinical picture presented by the patient and the association between generalized tuberculosis and chronic alcoholism are commented upon.

[Intracranial tuberculoma: clinical and pathological aspects]

A retrospective analysis of 19.760 consecutive autopsies and 72.972 biopsies in a period of over 41 years disclosed 24 intracranial tuberculomas in 17 patients, representing 4,2% of the intracranial space-occupying lesions. Most intracranial tuberculomas were found the cerebral hemispheres whereas one third of them were located in the cerebellum. About two thirds of the patients were younger than 20 years old. The clinical picture of intracranial tuberculomas is similar to that of other space-occupying lesions, comprising signs of raised intracranial pressure and signs related to the anatomical site of the lesion.

Tuberculose meningo-encefalica na infância: estudo anatomo-patologico de 10 casos

Estudo anátomo-patológico de 10 casos de tuberculose do SNC em crianças, com idade inferior a 10 anos. São enfatizadas as alterações macro e microscópicas produzidas pela tuberculose nas meninges, parênquima nervoso e vasos. Os achados clínicos e patológicos são discutidos e correlacionados com a literatura. Os autores concluem que: 1) a lesão, em crianças com tuberculose do SNC, é geralmente uma meningoencefalite proliferativa; 2) o parênquima nervoso pode ser afetado por propagação contígua do processo tuberculoso ou por alterações circulatórias secundárias a lesões arteriais; 3) por causa da localização dos vasos endocranianos no espaço sub-aracnóideo, eles são geralmente lesados pelo processo inflamatório, que determina uma endarterite obliterante, a qual pode ser observada por angiografia carotídea.

[Inflammatory chronic processes of the central nervous system. Neurosurgical aspects]

A study into the neurosurgical approach to thirty-five patients with increased intracranial pressure due to inflamatory diseases affecting the central nervous system and meninges is reported. The entitites under consideration were found to have similar surgical aspects despite the heterogeneity of etiologic agents. As regards the surgical treatment, two groups of cases were recognized. Group 1 comprises 7 patientes with symptoms of a space-occupying lesion; in these patients craniotomies were performed with good results. Group 2 included the remainder 28 cases with acquired hydrocephalus. In this group differents methods for ventricular drainage were used, but ventriculo-auriculostomy and specially ventriculo-peritoneal shunts proved to give more gratifying results. Chemotherapy was administred when the etiologic agent was disclosed. Corticosteroids were institued to reduce inflammatory reations and cerebral edema. A review of the literature supported the practical classification and surgical techniques employed.

[Intracraniel tuberculoma. Report of 2 cases]

Os tuberculomas intracranianos são de difícil diagnóstico pré-operatório e, atualmente, constituem raridade em alguns países. Os autores relatam dois casos, com extirpação total do processo, em que o diagnóstico foi feito após intervenção cirúrgica. São comentados vários aspectos referentes ao diagnóstico e a conduta terapêutica nos tuberculomas intracranianos.