Cerebral Tuberculoma with Mild Posterior Cervical Pain as the Main Symptom Despite Extensive Brain Lesions
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- Saitoh Ban-yu
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Japan Department of Neurology, Brain and Nerve Center, Fukuoka Central Hospital, International University of Health and Welfare, Japan Translational Neuroscience Center, Graduate School of Medicine, and School of Pharmacy at Fukuoka, International University of Health and Welfare, Japan
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- Tateishi Takahisa
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Japan Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Japan
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- Yoshimura Motoi
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Japan Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Japan
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- Suzuki Satoshi O.
- Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Japan
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- Isobe Noriko
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Japan
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- Iwaki Toru
- Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Japan
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- Kira Jun-ichi
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Japan Department of Neurology, Brain and Nerve Center, Fukuoka Central Hospital, International University of Health and Welfare, Japan Translational Neuroscience Center, Graduate School of Medicine, and School of Pharmacy at Fukuoka, International University of Health and Welfare, Japan
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Description
<p>A 59-year-old woman with a diabetes history experienced mild neck pain. A neurological examination revealed only mild neck stiffness. Magnetic resonance imaging showed extensive T2-weighted high-intensity lesions with patchy gadolinium enhancement mainly involving the white matter in the right parietal lobe. A cerebrospinal fluid analysis revealed increased protein levels and pleocytosis. While QuantiFERON-TB Gold was positive, computed tomography (CT) and fluorodeoxyglucose on positron emission tomography-CT of the whole body showed no abnormal accumulation, suggesting tuberculosis. A brain biopsy revealed cerebral tuberculoma. As cerebral tuberculoma can show minimal neurological symptoms despite extensive lesions, a cautious examination and early treatment are required to prevent a devastating prognosis. </p>
Journal
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- Internal Medicine
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Internal Medicine 61 (19), 2941-2945, 2022-10-01
The Japanese Society of Internal Medicine