Tuberculomas intracranianos: estudo clínico e patológico

Lana-Peixoto, Marco Aurélio; Pitella, Jose Eymard Homem; Bambirra, Eduardo Alves; Arouca, Eustaquio Martins Gomes

doi:10.1590/S0004-282X1982000200001

Resumos

Vinte e quatro tuberculomas intracranianos foram encontrados em 17 pacientes numa análise retrospectiva de 19.760 autópsias e 72.972 biópsias consecutivas, num período de 41 anos e 4 meses. Os 17 pacientes representaram 4,2% dos casos das lesões expansivas intracranianas. A maioria dos tuberculomas se localizava nos hemisférios cerebrais, e um terço deles, no cerebelo. Cerca de 65% dos pacientes tinham idade inferior a 20 anos. O quadro clínico é semelhante ao das outras lesões expansivas intracranianas estando relacionado à hipertensão intracraniana e à localização da lesão. Os dados encontrados são comparados aos das várias séries publicadas em diferentes países.

A retrospective analysis of 19.760 consecutive autopsies and 72.972 biopsies in a period of over 41 years disclosed 24 intracranial tuberculomas in 17 patients, representing 4,2% of the intracranial space-occupying lesions. Most intracranial tuberculomas were found the cerebral hemispheres whereas one third of them were located in the cerebellum. About two thirds of the patients were jounger than 20 years old. The clinical picture of intracranial tuberculomas is similar to that of other space-occupying lesions, comprinsing signs of raised intracranial pressure and signs related to the anatomical site of the lesion.

Tuberculomas intracranianos: estudo clínico e patológico

Intracranial tuberculoma: clinic pahtological study of 17 cases

Marco Aurélio Lana-Peixoto^I; Jose Eymard Homem Pitella^I; Eduardo Alves Bambirra^I; Eustaquio Martins Gomes Arouca^II

^IProfessor-Assistente. Departamento de Neurologia e Anatomia Patológica da Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte

^IIAcadêmico. Departamento de Neurologia e Anatomia Patológica da Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte

RESUMO

Vinte e quatro tuberculomas intracranianos foram encontrados em 17 pacientes numa análise retrospectiva de 19.760 autópsias e 72.972 biópsias consecutivas, num período de 41 anos e 4 meses. Os 17 pacientes representaram 4,2% dos casos das lesões expansivas intracranianas. A maioria dos tuberculomas se localizava nos hemisférios cerebrais, e um terço deles, no cerebelo. Cerca de 65% dos pacientes tinham idade inferior a 20 anos. O quadro clínico é semelhante ao das outras lesões expansivas intracranianas estando relacionado à hipertensão intracraniana e à localização da lesão. Os dados encontrados são comparados aos das várias séries publicadas em diferentes países.

SUMMARY

A retrospective analysis of 19.760 consecutive autopsies and 72.972 biopsies in a period of over 41 years disclosed 24 intracranial tuberculomas in 17 patients, representing 4,2% of the intracranial space-occupying lesions. Most intracranial tuberculomas were found the cerebral hemispheres whereas one third of them were located in the cerebellum. About two thirds of the patients were jounger than 20 years old. The clinical picture of intracranial tuberculomas is similar to that of other space-occupying lesions, comprinsing signs of raised intracranial pressure and signs related to the anatomical site of the lesion.

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Departamento de Neurologia - Faculdade de Medicina da Universidade Federal de Minas Gerais - Avenida Alfredo Balena, 190 - 30000 Belo Horizonte, MO - Brasil.

1. ANDERSON, J. M. .& MACMILLAN, J. J. - Intracranial tuberculoma: an increasing problem in Britain. J. Neurosurg. Psychiat. (London) 38:194, 1975.
2. ARSENI, C. - Two hundred and one cases of intracranial tuberculomas treated surgically. J. Neurol. Neurosurg. Psychiat. 21:308, 1958.
3. ASENJO, A., VALLADARES, H. & FIERRO, J. - Tuberculomas of the brain. Arch. Neurol. Psychiat. (Chicago) 65:146, 1951.
4. BAGCHI, A. - The intracranial tuberculomas. J. Ind. Med. Assoc. 37:429, 1961.
5. BALAPARAMESWARARAO, S. DINAKAR, I. - Tuberculomas of the brain. Int. Surg. 57:216, 1972.
6. BARBOSA, L. M. L. & TEIXEIRA, L. C. - Tuberculomas cerebrais múltiplos em lactente. Arq. Neuro-Psiquiat. (São Paulo) 30:72, 1972
7. CASTRO, M. & LEPE, A. - Cerebral tuberculoma. Acta. Radiol. 1:827, 1963.
8. CUSHING, H. - Intracranial Tumors: note upon a series of two thousand verified cases with surgical mortality percentages the reto. Charles C. Thomas Publisher, Springfield, (Illinois) 1932.
9. DASTUR, D. K., LALITHA, V. S. & PRABHAKAR, V. - Pathological analysis of intracranial space-occupying lesions in 1000 cases including children: age, sex and pattern, and the tuberculomas. J. Neurol. Sci. 6:575, 1968.
10. DASTUR, D. K. & LALITHA, V. S. - The many facets of neurotuberculosis: an epitome of neuropathology. In Progress in Neuropathology, ed. H. M. Zimmerman, Grune & Stratton, Inc., New York, 1973.
11. DASTUR, H. M. - A tuberculoma review with some personal experiences. Neurol. India 20:111, 1972.
12. DASTUR, H. M. & DESAI, A. D. - A comparative study of brain tuberculomas and gliomas, based upon 107 cases records of each. Brain 88:375, 1965.
13. GARCIA-LOPES, P., WANDERLEY, E. C, MORAES, L. M. C. Jr., MACIEL, D. R. K., RIBEIRO, J. I. C. & PASSOS, E. M. - Tuberculomas intracranianos: relato de dois casos. Arq. Neuro-Psiquiat. (São Paulo) 31:132, 1973.
14. GARLAND, H. G. & ARMITAGE, G. - Intracranial tuberculoma. J. Path. Bact. 37:461, 1933.
15. HIGAZI, I. - Tuberculoma of the brain: a clinical and angiographic study. J. Neurosurg. 20:378, 1963.
16. KAUFMAN, D. M. & LEEDS, N. E. - Computed tomography in the diagnosis of intracranial abscesses: brain abscesses, subdural empyema and epidural empyema. Neurology (Minneapolis) 27:1069, 1977.
17. LANA-PEIXOTO, M. A., BAMBIRRA, E. A. & PITELLA, J. E. H. - Optic nerve tuberculoma: a case report. Arch. Neurol. (Chicago) 37:186, 1980.
18. LEIBROCK, L., EPSTEIN, M. H. & RIBOCK, J. D. - Cerebral tuberculoma localized by EMI scan. Surg. Neurol. 5:305, 1976.
19. LEVY, L. F. & AXTON, J. - Neurosurgery in Rhodesia. In Tropical Neurology, ed. J. D. Spillane, London, Oxford University Press, 1973.
20. MATHAI, K. V. & CHANDY, J. - Tuberculous infections of the nervous system. Clin. Neurosurg. 14:145, 1967.
21. MAYERS. M. M., KAUFMAN, D. M. & MILLER, M. H. - Recent cases of intracranial tuberculomas. Neurology (Minneapolis) 28:256, 1978.
22. NORTHFIELD, D. W. C. - The Surgery of the Central Nervous System. Blacwell, Oxford, 1973.
23. ODEKU, E. L. & ADELOYE, A. - Cerebral tuberculomas in Nigerian patients. Trop. Geograph. Med. 21:293, 1969.
24. RAMAMURTHI, B. - Experiences with tuberculomas of the brain. Ind. J. Surg. 18:452, 1956.
25. RAMAMURTHI, B. & VALADARAJAN, M. G. - Diagnosis of tuberculomas of the brain. J. Neurosurg. 18:1-7, 1961.
26. SCHLERNITZAUER, D. A., HODGES, F. L. & BAGAN, M. - Tuberculoma of the left optic nerve and chiasm. Arch. Ophthalmol. 85:75, 1971.
27. SIBLEY, W. A. & O'BRIEN, J. L. - Intracranial tuberculomas: A review of clinical features and treatment. Neurology (Minneapolis) 6:157, 1956.
28. STARR, M. A. - Tumours of the brain in childhood: their variety and situation with special reference to their treatment by surgical interference. Med. News 54:29, 1889.
29. STEAD, W. N. - Pathogenesis of the sporadic cases of tuberculosis. N. Engl. J. Med. 277:1008, 1967.
30. TOLOSA, A., TENUTO, R. & SILVA, J. A. C. Jr. - Tuberculoma cerebral: extirpação cirúrgica. Arq. Neuro-Psiquiat. (São Paulo) 4:28, 1946.
31. WALSH, F. B. & HOYT, W. F. - Clinical Neurophthalmology, 3rd. ed., Williams & Wilkins, Baltimore, 1969.
32. WILKINSON, H. A., FERRIS, E. J., MUGGIA, A. L. & CANTU, R. C. - Central nervous system tuberculosis: a persistent disease. J. Neurosurg. 34:15, 1971.
33. WILSON G., RUPP, C. & BARTLE, H. Jr. - Tuberculoma of the central nervous system. Trans. Amer. Neurol. Assoc. 40-45, 1941.

Datas de Publicação

Publicação nesta coleção
16 Ago 2012
Data do Fascículo
Jun 1982

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ANDERSON, J. M. .& MACMILLAN, J. J. - Intracranial tuberculoma: an increasing problem in Britain. J. Neurosurg. Psychiat. (London) 38:194, 1975.

[2] 2. ARSENI, C. - Two hundred and one cases of intracranial tuberculomas treated surgically. J. Neurol. Neurosurg. Psychiat. 21:308, 1958.

[3] 3. ASENJO, A., VALLADARES, H. & FIERRO, J. - Tuberculomas of the brain. Arch. Neurol. Psychiat. (Chicago) 65:146, 1951.

[4] 4. BAGCHI, A. - The intracranial tuberculomas. J. Ind. Med. Assoc. 37:429, 1961.

[5] 5. BALAPARAMESWARARAO, S. DINAKAR, I. - Tuberculomas of the brain. Int. Surg. 57:216, 1972.

[6] 6. BARBOSA, L. M. L. & TEIXEIRA, L. C. - Tuberculomas cerebrais múltiplos em lactente. Arq. Neuro-Psiquiat. (São Paulo) 30:72, 1972

[7] 7. CASTRO, M. & LEPE, A. - Cerebral tuberculoma. Acta. Radiol. 1:827, 1963.

[8] 8. CUSHING, H. - Intracranial Tumors: note upon a series of two thousand verified cases with surgical mortality percentages the reto. Charles C. Thomas Publisher, Springfield, (Illinois) 1932.

[9] 9. DASTUR, D. K., LALITHA, V. S. & PRABHAKAR, V. - Pathological analysis of intracranial space-occupying lesions in 1000 cases including children: age, sex and pattern, and the tuberculomas. J. Neurol. Sci. 6:575, 1968.

[10] 10. DASTUR, D. K. & LALITHA, V. S. - The many facets of neurotuberculosis: an epitome of neuropathology. In Progress in Neuropathology, ed. H. M. Zimmerman, Grune & Stratton, Inc., New York, 1973.

[11] 11. DASTUR, H. M. - A tuberculoma review with some personal experiences. Neurol. India 20:111, 1972.

[12] 12. DASTUR, H. M. & DESAI, A. D. - A comparative study of brain tuberculomas and gliomas, based upon 107 cases records of each. Brain 88:375, 1965.

[13] 13. GARCIA-LOPES, P., WANDERLEY, E. C, MORAES, L. M. C. Jr., MACIEL, D. R. K., RIBEIRO, J. I. C. & PASSOS, E. M. - Tuberculomas intracranianos: relato de dois casos. Arq. Neuro-Psiquiat. (São Paulo) 31:132, 1973.

[14] 14. GARLAND, H. G. & ARMITAGE, G. - Intracranial tuberculoma. J. Path. Bact. 37:461, 1933.

[15] 15. HIGAZI, I. - Tuberculoma of the brain: a clinical and angiographic study. J. Neurosurg. 20:378, 1963.

[16] 16. KAUFMAN, D. M. & LEEDS, N. E. - Computed tomography in the diagnosis of intracranial abscesses: brain abscesses, subdural empyema and epidural empyema. Neurology (Minneapolis) 27:1069, 1977.

[17] 17. LANA-PEIXOTO, M. A., BAMBIRRA, E. A. & PITELLA, J. E. H. - Optic nerve tuberculoma: a case report. Arch. Neurol. (Chicago) 37:186, 1980.

[18] 18. LEIBROCK, L., EPSTEIN, M. H. & RIBOCK, J. D. - Cerebral tuberculoma localized by EMI scan. Surg. Neurol. 5:305, 1976.

[19] 19. LEVY, L. F. & AXTON, J. - Neurosurgery in Rhodesia. In Tropical Neurology, ed. J. D. Spillane, London, Oxford University Press, 1973.

[20] 20. MATHAI, K. V. & CHANDY, J. - Tuberculous infections of the nervous system. Clin. Neurosurg. 14:145, 1967.

[21] 21. MAYERS. M. M., KAUFMAN, D. M. & MILLER, M. H. - Recent cases of intracranial tuberculomas. Neurology (Minneapolis) 28:256, 1978.

[22] 22. NORTHFIELD, D. W. C. - The Surgery of the Central Nervous System. Blacwell, Oxford, 1973.

[23] 23. ODEKU, E. L. & ADELOYE, A. - Cerebral tuberculomas in Nigerian patients. Trop. Geograph. Med. 21:293, 1969.

[24] 24. RAMAMURTHI, B. - Experiences with tuberculomas of the brain. Ind. J. Surg. 18:452, 1956.

[25] 25. RAMAMURTHI, B. & VALADARAJAN, M. G. - Diagnosis of tuberculomas of the brain. J. Neurosurg. 18:1-7, 1961.

[26] 26. SCHLERNITZAUER, D. A., HODGES, F. L. & BAGAN, M. - Tuberculoma of the left optic nerve and chiasm. Arch. Ophthalmol. 85:75, 1971.

[27] 27. SIBLEY, W. A. & O'BRIEN, J. L. - Intracranial tuberculomas: A review of clinical features and treatment. Neurology (Minneapolis) 6:157, 1956.

[28] 28. STARR, M. A. - Tumours of the brain in childhood: their variety and situation with special reference to their treatment by surgical interference. Med. News 54:29, 1889.

[29] 29. STEAD, W. N. - Pathogenesis of the sporadic cases of tuberculosis. N. Engl. J. Med. 277:1008, 1967.

[30] 30. TOLOSA, A., TENUTO, R. & SILVA, J. A. C. Jr. - Tuberculoma cerebral: extirpação cirúrgica. Arq. Neuro-Psiquiat. (São Paulo) 4:28, 1946.

[31] 31. WALSH, F. B. & HOYT, W. F. - Clinical Neurophthalmology, 3rd. ed., Williams & Wilkins, Baltimore, 1969.

[32] 32. WILKINSON, H. A., FERRIS, E. J., MUGGIA, A. L. & CANTU, R. C. - Central nervous system tuberculosis: a persistent disease. J. Neurosurg. 34:15, 1971.

[33] 33. WILSON G., RUPP, C. & BARTLE, H. Jr. - Tuberculoma of the central nervous system. Trans. Amer. Neurol. Assoc. 40-45, 1941.