A case of intracranial tuberculoma and optic disc tuberculoma suspected by miliary tuberculosis

Intracranial tuberculoma results from hematogenous spread of pulmonary, intestinal or urogenital tuberculosis. However, it might be caused by pulmonary tuberculosis, mainly. Clinically, symptoms of intracranial tuberculoma are headache and seizure, its symptoms are similar to intracranial tumor. A 25-year-old-unmarried shopgirl visited this hospital because of headache, dizziness and visual disturbance for a couple weeks in Sep. 1995. She had been treated with anti-tuberculosis agents of miliary tuberculosis during the past nine months period. Brain MRI revealed intracranial tuberculoma and brain edema but not involved optic nerve. Ophthalmic examination revealed severe papilledema and splinter hemorrhage with bitemporal hemianopsis and central scotoma. This finding was strongly suggested of optic disc tuberculoma. Her symptoms became much better following repeated retrobulbar steroid injection with continuous anti-tuberculosis agents. We report an interesting case with intracranial tuberculoma and optic disc tuberculoma associated by miliary tuberculosis during anti-tuberculous treatment.