RESUMO
Objetivos: Describir las características diagnosticas epidemiológicas, clínicas, de LCR, imagenológicas de tuberculosis intracraneal (TBC Meníngea, Tuberculoma) en hospitalizados del Servicio de Neurología del Hospital Nacional Guillermo Almenara Irigoyen 2008-2012. Materiales y Métodos: Se seleccionó la historia de todos los pacientes hospitalizados en el Servicio de Neurología del Hospital Nacional Guillermo Almenara Irigoyen entre los años 2008 y 2012 con diagnóstico de tuberculosis intracraneal confirmada o sospechosa con un número total de 26 casos. Se obtuvo datos de filiación, antecedentes epidemiológicos, historia de enfermedad, examen neurológico de los 26 pacientes; estudios en LCR: bioquímicos y citoquímicos en 25 pacientes, bk en 20 pacientes, ADA en 20 pacientes, PCR en 8 pacientes y cultivo en 7 pacientes; a los 26 casos se realizó TAC de encéfalo, y a 17 RMN de encéfalo. Resultados: En el Servicio de Neurología del Hospital Nacional Guillermo Almenara referente de la red Almenara se hospitalizaron 26 casos de Tuberculosis Intracraneal (1.47 por ciento de hospitalizados en el Servicio de Neurología) del año 2008 al 2012, de los cuales 19 casos (73.07 por ciento) fueron Tuberculoma cerebral y 07 casos (26.93 por ciento) Meningoencefalitis Tuberculosa (MEC TBC); 17 casos (65.381 por ciento) fueron de sexo masculino y 9 (35.62 por ciento) de sexo femenino, la mayoría estuvieron comprendidos entre el segmento 26 a 40 años con 14 (54.85 por ciento) casos siendo predominante tanto para tuberculoma cerebral 11 (57.89 por ciento), como para MEC TBC 03 (42.86 por ciento); la mayoría provinieron de la Red Almenara 20 (76.91 por ciento) a diferencia de otros 6 casos (23.08 por ciento) que provinieron de otras redes; el tipo de seguro en su mayoría fue obligatorio (principal aportante activo del seguro social) con 15 (57.68 por ciento) pacientes. De los antecedentes epidemiológicos 08 pacientes (30.77 por ciento) tuvieron contacto familiar de tuberculosis...
Objectives: Describe diagnostic epidemiological, clinical, CSF, imaging of intracranial tuberculosis (TBC Meningeal, Tuberculoma) in hospitalized Neurology Service of the National Hospital Guillermo Almenara Irigoyen 2008-2012. Materials and methods: The history of all patients hospitalized in the Neurology Service of Guillermo Almenara Irigoyen National Hospital between 2008 and 2012 confirmed or suspected diagnosis of a total number of 26 cases intracranial tuberculosis was selected. Personal data, epidemiological history, history of disease, neurological examination of 26 patients was obtained; CSF studies: Biochemical and cytochemical in 25 patients, 20 patients bk, ADA in 20 patients, 8 patients PCR and culture in 7 patients; the 26 cases of brain CT scan was performed, and 17 NMR brain. Results: In the Neurology Service of the Guillermo Almenara National Hospital, Almenara benchmark of 26 cases of Tuberculosis Intracranial (1.47 per cent of hospitalized in the Neurology Service) they were hospitalized 2008 to 2012, of which 19 cases (73.07 per cent) were Tuberculoma cerebral and 07 cases (26.93 per cent) meningoencephalitis Tuberculous (TBC MEC); 17 cases (65.381 per cent) were males and 9 (35.62 per cent) were female, most were between the segment 26 to 40 years with 14 (54.85 per cent) cases being predominant both cerebral tuberculoma 11 (57.89 per cent) and for MEC TBC 03 (42.86 per cent); most carne from Beacon Red 20 (76.91 per cent) unlike another 6 cases (23.08 per cent) that carne from other networks; the type of insurance was mostly compulsory (primary active contributor of social insurance) 15 (57.68 per cent) patients. The epidemiological history of 08 patients (30.77 per cent) had household contact with tuberculosis; 03 (11.54 per cent) patients had associated immune suppression, with only 3 cases of TBC MEC (MEC 42.86 per cent). The most common general symptoms were headache in 20 cases (76.92 per cent), followed by nausea and vomiting in...
Assuntos
Masculino , Feminino , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Tuberculoma Intracraniano/diagnóstico , Tuberculoma Intracraniano/epidemiologia , Tuberculose do Sistema Nervoso Central , Estudos Observacionais como Assunto , Estudos Retrospectivos , Relatos de CasosRESUMO
A solitary tuberculous brain lesion (STBL) can be difficult to distinguish from a glioma, metastasis or other infectious disease, especially from a pyogenic brain abscess. We analyzed the clinical characteristics, diagnostic procedures and outcomes of 24 patients with STBL diagnosed in three centers from France, India and Mexico. We also reviewed 92 STBL cases previously reported in the literature. General symptoms were found in 54% of our patients, including enlarged lymph nodes in 20%. Cerebrospinal fluid was typically abnormal, with lymphocytic pleocytosis and a high protein level. The lung CT scan was abnormal in 56% of patients, showing lymphadenopathy or pachipleuritis. Brain MRI or CT was always abnormal, showing contrast-enhanced lesions. Typically, MRI abnormalities were hypointense on T1-weighted sequences, while T2-weighted sequences showed both a peripheral hypersignal and a central hyposignal. The diagnosis was documented microbiologically or supported histologically in 71% of cases. Clinical outcome was good in 83% of cases.
Assuntos
Tuberculoma Intracraniano/epidemiologia , Adolescente , Adulto , Idoso , Antituberculosos/uso terapêutico , Abscesso Encefálico/diagnóstico , Neoplasias Encefálicas/diagnóstico , Comorbidade , Diagnóstico Diferencial , Feminino , Febre/etiologia , França/epidemiologia , Glioma/diagnóstico , Cefaleia/etiologia , Humanos , Índia/epidemiologia , Imageamento por Ressonância Magnética , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Marrocos/etnologia , Mycobacterium tuberculosis/isolamento & purificação , Avaliação de Sintomas , Tomografia Computadorizada por Raios X , Tuberculoma Intracraniano/diagnóstico , Tuberculoma Intracraniano/tratamento farmacológico , Tuberculoma Intracraniano/patologia , Tuberculose Pulmonar/diagnóstico por imagem , Tuberculose Pulmonar/epidemiologia , Adulto JovemRESUMO
Neurologic complications associated with human immunodeficiency virus type 1 (HIV-1) infection vary geographically. To understand the pattern of HIV-associated neurologic complications in Mexico, 120 AIDS patients from Mexico City, Mexico, and 500 AIDS patients from Houston, Texas, were studied cross-sectionally and retrospectively. Neurologic, laboratory, imaging, and pathologic examinations identified 40 Mexican patients and 130 U.S. patients with neurologic complications. Whereas AIDS dementia complex was the most common neurologic manifestation in both groups, intracranial tuberculoma was present only in the Mexican population (10%). Primary brain lymphoma was more prevalent in the U.S. population (8.4%). The different findings in the Mexican population likely reflect afflictions common to developing countries--a high prevalence of tuberculosis and a high mortality rate. These conditions preclude complications such as lymphoma, which develop later in the natural course of HIV infection.