Brazilian Neurosurgery (Mar 2019)

Tuberculoid Granuloma in the Brainstem: Case Report

  • Tobias Ludwig,
  • Luiz Pedro Willimann Rogerio,
  • Marcelo Martins dos Reis,
  • Leandro Pelegrini de Almeida,
  • Gabriel Greggianin Frizzon,
  • Guilherme Finger,
  • Pasquale Gallo,
  • Jennyfer Paulla Galdino Chaves

DOI
https://doi.org/10.1055/s-0036-1594250
Journal volume & issue
Vol. 38, no. 01
pp. 064 – 067

Abstract

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Meningitis or meningoencephalitis are the most common presentations of Koch bacilli infection on the central nervous system (CNS), especially in immunosuppressed patients, in whom the bacilli normally reaches the meninges and the cerebral parenchyma.. A least common pathological presentation is the tumoral growth pattern disease known as tuberculoma. This pathological entity is more common in the cerebral hemispheres and is rarely located in the brainstem. The present case report describes a case of a 55-year-old patient under regular antiretroviral therapy who was hospitalized with signs of brainstem and cerebellar disturbances. Computed tomography (CT) and magnetic resonance imaging (MRI) of the brain showed an exophytic lesion in the dorsal region of the pons. The patient underwent total resection of the lesion and the histopathologic analysis was consistent with a tuberculoma.

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