Rate of resolution of histologically verified intracranial tuberculomas

Isaac, Poonnoose Santosh ; Vedantam, Rajshekhar (2003) Rate of resolution of histologically verified intracranial tuberculomas Neurosurgery, 53 (4). pp. 873-879. ISSN 0148-396X

Full text not available from this repository.

Official URL: http://journals.lww.com/neurosurgery/Abstract/2003...

Related URL: http://dx.doi.org/10.1227/01.NEU.0000083553.25421.6F

Abstract

Objective: The goal of this study was to determine the rate of radiological resolution of histopathologically proven tuberculomas treated with antituberculous therapy (ATT). The effects of the size of the tuberculomas, the number of tuberculomas, and the addition of corticosteroid therapy on the rate of resolution of the tuberculomas were also studied. Methods: Twenty-eight patients (age range, 5-48 yr; 14 male and 14 female patients) with histologically proven intracranial tuberculomas were prospectively monitored with contrast-enhanced computed tomographic scans. The patients received ATT consisting of rifampicin and isoniazid for a period of 18 months, with ethambutol and/or pyrazinamide for a minimum of 3 months. Fifteen patients also received corticosteroid therapy for 1 to 6 weeks. Of the 28 patients, 17 patients underwent partial excision, 6 underwent open biopsy, and 5 underwent stereotactic biopsy of their tuberculomas. Results: Kaplan-Meier analysis revealed that, after 9 months of ATT, only 18.2% of the patients demonstrated complete resolution of their tuberculomas; even after 18 months of ATT, 69.2% of the patients had residual lesions. By 24 months, 54% of the patients demonstrated complete resolution of their tuberculomas. Although the number of tuberculomas, corticosteroid administration, prior treatment with ATT, and the duration of symptoms before presentation (<6 mo versus >6 mo) did not influence the rate of resolution, larger tuberculomas (maximal size, >4 cm) were observed to resolve more slowly than smaller tuberculomas (<4 cm) (P = 0.02). Conclusion: More than two-thirds of patients with partially excised or biopsied intracranial tuberculomas exhibited persistent lesions on computed tomographic scans, even after 18 months of ATT. Therefore, the duration of ATT for patients with intracranial tuberculomas should be based on the radiological responses of the tuberculomas. Our data suggest that some patients with intracranial tuberculomas might require prolonged periods of ATT.

Item Type:Article
Source:Copyright of this article belongs to Lippincott Williams and Wilkins.
Keywords:Antituberculous Therapy; Computed Tomography; Tuberculosis
ID Code:67167
Deposited On:29 Oct 2011 03:51
Last Modified:29 Oct 2011 03:51

Repository Staff Only: item control page