Granulomas del encéfalo. A propósito de un caso

Abstract

Introduction: Diagnosis of intracranial granuloma is a clinical challenge, especially in patients without pathological medical history. We present the case of a young, immunocompetent patient, operated for a brain tumor and confirmed tuberculoma by biopsy. A succinct review on the subject is offered. Clinical case: A 29-year-old patient with no pathological history, debuted with headache and generalized tonic clonic seizure. Physical examination at admission showed no alterations. Magnetic Resonance of the brain showed an intraaxial right frontal tumor, with great perilesional edema and mass effect. Contrast computed tomography of the thorax, abdomen and pelvis was normal. Bloc resection of the lesion was performed and the excisional biopsy confirmed a tuberculoma. Conclusions: Clinical uspicion is essential for the diagnosis of intracranial granulomas, taking into account the epidemiological antecedents, the detection of  immunodepression states and concomitant systemic lesions. Several neuroimaging, immunological and microbiological tests are helpful, although the histopathological study of the lesions is crucial.