Management of intracranial tuberculoma in children

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Abstract
Thirty-one patients were studied during a period of 3 years in order to identify features helpful for the diagnosis of tuberculoma. Sixteen had a history of pyrexia, 4 had had contact with cases of tuberculosis, the tuberculin test was positive in 15, the erythrocyte sedimentation rate (ESR) was elevated in 23, and 5 had concomitant tuberculous infections. Three had multiple lesions and 10 showed CT scan features suggestive of tuberculoma. Nineteen patients were successfully treated with drugs alone; seven needed surgery because they failed to respond to drugs clinically or because CT indicated no improvement. One patient proved to have a tumor, having shown an absence of response to drugs; four were operated on without drug trial because they were thought to have a tumor, and 1 needed surgery because of the mass effect of a very large tuberculoma. Infratentorial lesions associated with hydrocephalus were treated with ventriculoperitoneal shunts.