Open AccessRuptured intraventricular tuberculous brain abscess mimicking cystic neoplasm: a case report
Author(s) -
Zakariae Benyaich,
Farouk Hajhoui,
Mehdi Laghmari,
H. Ghannane,
S. Aït Benali
Publication year - 2021
Publication title -
the pan african medical journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.287
H-Index - 30
ISSN - 1937-8688
DOI - 10.11604/pamj.2021.39.122.29369
Subject(s) - medicine , hydrocephalus , abscess , differential diagnosis , brain abscess , lesion , lateral ventricles , magnetic resonance imaging , tuberculosis , third ventricle , endoscopic third ventriculostomy , ventriculostomy , radiology , pathology , surgery , anatomy
Central nervous system (CNS) tuberculosis is a potentially life-threatening condition that may manifest in different forms and simulate other pathologies. It rarely involves the ventricles and the occurrence of primary intraventricular tuberculous brain abscess (TBA) has exceptionally been reported. As far as we know, ruptured intraventricular TBA has not been described before. An immunocompetent 56-years-old man was admitted for sub-acute intracranial hypertension with behaviour disorders. Cranial magnetic resonance imaging (MRI) showed a cystic lesion of the third ventricle containing fluid-fluid level with biventricular hydrocephalus and debris in the occipital horns. A ruptured cystic neoplasm was first considered. The patient underwent surgery via a right transcortical transventricular approach, combining both microscope and endoscope. The puncture of the lesion brought pus and the Ziehl-Neelson (ZN) staining demonstrated acid-fast bacilli. Intraventricular tuberculous abscess is an extremely rare condition that can take an unusual radiological appearance. This observation highlights the consideration of tuberculosis within the list of differential diagnosis of intraventricular cystic lesions in immunocompetent hosts.