Intracranial tuberculomas. An assessment of a therapeutic 4-drug trial in 35 children

Abstract

35 children with suspected tuberculomas of the brain were given a therapeutic 4-drug trial of isoniazid, rifampicin, pyrazinamide and ethambutol. Their clinical and computed tomographic (CT) appearances were analysed retrospectively: 32 responded well to treatment with recognizable improvement on CT after 6 weeks. Three patients did not respond. One of these non-responders had a surgically removed temporal cystic astrocytoma. The majority presented with focal seizures and had a single hemispheral lesion. 14% had multiple lesions, 6% were in the cerebellum. Only 2 patients had raised intracranial pressure and required ventriculoperitoneal shunting.