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KMID : 0372819980210010027
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Eulji Medical Journal
1998 Volume.21 No. 1 p.27 ~ p.34
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Ptosis, Diplopia, and Tongue Deviation as a Presenting Feature in Tuberculoma of the Cerebellum
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권혜영/Kwon Hye Young
박유비/김후원/천대웅/안병철/오건세/Park Yu Mi/Kim Hu Won/Tchun Dae Woong/Ahn Byeong Cheol/Oh Gun Sei
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Abstract
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Backgroud : The most common sites of intracranial tuberculoma in adults are the cerebral hemisphere and the basal ganglia. In patients over 20years age, tuberculomas in the posterior fossa have been rarely reported . A case of a solitary cerebellar tuberculoma in young male is presented. The patient showed ptosis, tongue deviation and diplopia.
Case description : A 20year-old male presented with ptosis in right eye and diplopia. Three months ago, diplopia and ptosis in left eye were developed and two weeks after then ptosis disappeared but diplopia persisted and waxed and waned. New ptosis in right eye was developed 10 days ago. Tl-weighted MR imaging revealed a low signal intensity area in left cerebellar hemisphere. T2-weighted MR imaging revealed a high signal intensity in same region. Postcontrast Tl weighted imaging showed multiple conglomerated nodules which had central hypointense area and peripheral ring enhancement. Histologic examination of the cervical lymph node showed chronic granulomatous inflammation with central caseation necrosis. After treatment with dexamethasone, the cerebellar mass was markedly reduced. Based on the histological diagnosis, We started antituberculosis therapy and thereafter the ptosis was subsided and diplopia and tongue deviation was improved.
Conclusion : We report a rare case of a young male with a tuberculoma in the cerebellar hemisphere, presented with ptosis, tongue deviation and diplopia.
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