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Practical Solutions and Value in Clinical Trial
Case Study: Multiple Brain Tuberculomas in the Subarachnoid Cisterns
- Recognition of Radiological Characteristics
- Development of Paradoxical Response during Antituberculosis Treatment
Brain tuberculoma within subarachnoid cisterns is rare in Japan, making diagnosis challenging. A 70-year-old woman with suspected tuberculous meningitis (TBM) was enrolled in a clinical trial for antituberculosis treatment (ATT).
Key Findings:
- CSF soluble interleukin-2 receptor level decreased significantly after initiating ATT.
- Contrast-enhanced MRI revealed multiple enhanced lesions within the subarachnoid cisterns, indicating tuberculoma development.
Practical Value:
- Serial MRIs are crucial in monitoring paradoxical response (PR) development in cisternal tuberculomas.
- Effective management of PR involves continuing ATT with adjunctive corticosteroids.
Full Research URL: Link
Author: Kazuma Sahara
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