Possible role of adjunctive thalidomide therapy in the resolution of a massive intracranial tuberculous abcess

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dc.contributor.authorSchoeman J.F.
dc.contributor.authorRavenscroft A.
dc.contributor.authorHartzenberg H.B.
dc.date.accessioned2011-05-15T16:16:02Z
dc.date.available2011-05-15T16:16:02Z
dc.date.issued2001
dc.description.abstractWe present the case of a young child who developed a massive tuberculous abscess of the posterior fossa while being treated for pulmonary tuberculosis. Clinical improvement after surgical excision of the abscess was followed by recurrence of symptoms of acutely raised intracranial pressure on standard antituberculosis and corticosteroid therapy. Magnetic resonance (MR) imaging of the brain showed that a multiloculated abscess had developed anterior to the excision site of the original abscess. The recurring abscess was partly excised and drained but could not be removed completely because of its proximity to the brain stem. Thalidomide, a potent inhibitor of tumour necrosis factor alpha (TNF-α), was added to the treatment regimen and resulted in marked clinical improvement with resolution of the abscess within 4 months. The remaining CT lesion had the appearance of a small granuloma. Both the clinical and the radiological response was maintained after 1 year of antituberculosis treatment.
dc.description.versionArticle
dc.identifier.citationChild's Nervous System
dc.identifier.citation17
dc.identifier.citation6
dc.identifier.issn02567040
dc.identifier.other10.1007/s003810000427
dc.identifier.urihttp://hdl.handle.net/10019.1/13604
dc.subjectcorticosteroid
dc.subjectethambutol
dc.subjectisoniazid
dc.subjectprednisone
dc.subjectpyrazinamide
dc.subjectrifampicin
dc.subjectthalidomide
dc.subjecttuberculin
dc.subjectabscess drainage
dc.subjectarticle
dc.subjectbrain abscess
dc.subjectbrain fourth ventricle
dc.subjectbrain ventricle peritoneum shunt
dc.subjectcase report
dc.subjectcomputer assisted tomography
dc.subjectconsciousness disorder
dc.subjectcraniotomy
dc.subjectdecerebration
dc.subjectdecompression surgery
dc.subjectdrug effect
dc.subjectfever
dc.subjectgranuloma
dc.subjecthuman
dc.subjecthydrocephalus
dc.subjecthyperreflexia
dc.subjectinfant
dc.subjectintracranial pressure
dc.subjectlung tuberculosis
dc.subjectmale
dc.subjectmydriasis
dc.subjectnuclear magnetic resonance imaging
dc.subjectpapilledema
dc.subjectposterior fossa
dc.subjectpostoperative period
dc.subjectpriority journal
dc.subjectrecurrent disease
dc.subjectsurgical drainage
dc.subjecttuberculin test
dc.subjecttuberculosis
dc.subjectvomiting
dc.subjectAntitubercular Agents
dc.subjectCombined Modality Therapy
dc.subjectDrug Therapy, Combination
dc.subjectHumans
dc.subjectInfant
dc.subjectMagnetic Resonance Imaging
dc.subjectMale
dc.subjectRecurrence
dc.subjectReoperation
dc.subjectThalidomide
dc.subjectTuberculoma, Intracranial
dc.subjectTumor Necrosis Factor-alpha
dc.titlePossible role of adjunctive thalidomide therapy in the resolution of a massive intracranial tuberculous abcess
dc.typeArticle
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