Tuberculous Brain Abscess: A Case Report

ABSTRACT

Tuberculous brain abscess is a rare form of the central nervous system tuberculosis. Clinical characteristics of the tuberculous brain abscess are symptoms and signs of intracranial hypertension rather than meningeal irritation. A 23-year-old man presented with headache and vomiting for 4 months. Neurological examination revealed mild left hemiparesis. Chest X-rays showed a large tuberculous cavity in the right upper lobe. Brain computed tomography scan revealed multiple ring enhancing cystic masses with marked edema and midline shift in the deep right temporo-occipital lobe. Without symptomatic relief with several months of antituberculous medication, the patient was subjected to stereotactic aspiration of the mass. Persistence of the abscess on postoperative CT scan rendered him to undergo right temporo-occipital craniotomy with removal of the remaining nodular mass. Follow up brain CT showed no residual abscess. He was discharged with no neurologic deficit. Having experienced this rare case with review on relevant literaturs, the authors suggest excision of the abscess cavity plays an important role to eradicate intracranial tuberculous abscess.