In a report from the Dept of Pediatrics, All India Inst of Applied Sciences, New Delhi, India, intracranial tuberculoma was found in 20 (24%) of 83 patients with partial seizures complicated by increased intracranial pressure, systemic tuberculosis or focal neurologic deficit and in 12 (22%) of 55 patients with tuberculous meningitis. CT lesions consisting of ring enhancement, discs, and irregular coalescing masses with edema regressed within 12 weeks of starting medical therapy. Surgical excision was not required. Medical management was advocated, with surgery limited to drug treatment failures. [1]
COMMENT. Tuberculoma mimics other space-occupying lesions and in India its reported prevalence has ranged from 4 to 40% of intracranial tumors. Effective chemotherapy and CT monitoring of treatment response have minimized the role of surgery.