| Rate of resolution of histologically verified intracranial tuberculomas. | |
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MedLine Citation:
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PMID: 14519219 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Santosh Isaac Poonnoose; Vedantam Rajshekhar |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Neurosurgery Volume: 53 ISSN: 0148-396X ISO Abbreviation: Neurosurgery Publication Date: 2003 Oct |
Date Detail:
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Created Date: 2003-10-01 Completed Date: 2003-11-06 Revised Date: 2008-02-21 |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: 873-8; discussion 878-9 Citation Subset: IM |
Affiliation:
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Department of Neurological Sciences, Christian Medical College and Hospital, Vellore, India. rajshekhar@cmcvellore.ac.in |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adrenal Cortex Hormones / therapeutic use Adult Antitubercular Agents / administration & dosage, therapeutic use* Biopsy / methods Child Child, Preschool Drug Administration Schedule Drug Therapy, Combination Female Humans Male Middle Aged Prospective Studies Stereotaxic Techniques Tomography, X-Ray Computed Treatment Outcome Tuberculoma, Intracranial / drug therapy*, pathology, radiography, surgery |
| Chemical | |
Reg. No./Substance:
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0/Adrenal Cortex Hormones; 0/Antitubercular Agents |
| Comments/Corrections | |
Comment In:
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Neurosurgery. 2005 Apr;56(4):E873
[PMID:
15818884
]
Neurosurgery. 2005 Mar;56(3):E629 [PMID: 18235261 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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