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Tuberculous encephalopathy without meningitis: Pathology and brain MRI findings

Authors
 Kim H.-J.  ;  Shim K.-W.  ;  Lee M.-K.  ;  Park M.-S.  ;  Kim S.-H.  ;  Kim E.-Y.  ;  Park S.  ;  Kim T.-S. 
Citation
 EUROPEAN NEUROLOGY, Vol.65(3) : 156-159, 2011 
Journal Title
EUROPEAN NEUROLOGY
ISSN
 0014-3022 
Issue Date
2011
MeSH
Adolescent ; Antitubercular Agents/therapeutic use ; Brain/pathology* ; Demyelinating Diseases/complications ; Demyelinating Diseases/drug therapy ; Demyelinating Diseases/pathology* ; Humans ; Magnetic Resonance Imaging ; Male ; Seizures/etiology ; Seizures/pathology ; Treatment Outcome ; Tuberculosis, Central Nervous System/complications ; Tuberculosis, Central Nervous System/drug therapy ; Tuberculosis, Central Nervous System/pathology*
Keywords
Tuberculous encephalopathy ; Demyelination ; Cell-mediated immunity ; Steroid
Abstract
Tuberculous encephalopathy (TBE) is an established disease entity of diffuse cerebral damage occurring with tuberculosis and an underlying immune pathogenesis. However, the presence of this disease entity remains controversial. We report a 15-year-old boy with seizures and a progressive decline of cognitive function. Brain MRI showed diffuse, hyperintense lesions in the white matter on a T2-weighted image, with gadolinium enhancement on a T1-weighted image. Brain biopsy revealed demyelination and granuloma in the white matter. Ziehl-Neelsen staining showed acid-fast bacilli in the granulomas. Antituberculous medication with concomitant steroid treatment resulted in radiological resolution in addition to clinical improvement. Clinicopathological evidence in this case provides additional convincing evidence of TBE as a disease entity distinct from tuberculous meningitis.
Full Text
http://www.karger.com/Article/FullText/324170
DOI
10.1159/000324170
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Se Hoon(김세훈) ORCID logo https://orcid.org/0000-0001-7516-7372
Kim, Eung Yeop(김응엽)
Kim, Tai Seung(김태승)
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Park, Soo Chul(박수철)
Shim, Kyu Won(심규원) ORCID logo https://orcid.org/0000-0002-9441-7354
Lee, Moon Kyu(이문규)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/93076
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