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What is the treatment for inflammatory granuloma?

Monday, 05 February 2007
Answered by: Dr. Debashish Chowdhury
Associate Professor of Neurology
G.B.Pant Hospital
New Delhi
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Q. I recently got a fit, involving my right hand. I underwent an MRI, which revealed a small ring-enhancing lesion in high frontal lobe in parasagittal location. Moderate perilesional oedema was seen. It displayed iso to hypo-intense signal on T2W images, and rest of the brain was normal. I found that the lesion was infected with TB. The doctor has started anti-tubercular treatment. How much time will it take to recover?

A.  You are suffering from a localiesd area of infection in your brain which in radiological terminology is called inflammatory granuloma. The imaging features suggest that it is likely to be tubercular in nature and hence it is called tuberculoma. However, ancillary investigations like certain blood tests, Montoux test and x-ray chest are needed and I hope these have been done in your case. Solitary tuberculomas usually respond well to anti tubercular treatment and the treatment needs to be given for long duration of time with periodic follow up. In addition, antiepileptic drug (s) need to be given to prevent the focal seizures, which happened in your case. Repeat scan should preferably be done at 3 months to see if the lesion has disappeared or regressed.

A.  You are suffering from a localiesd area of infection in your brain which in radiological terminology is called inflammatory granuloma. The imaging features suggest that it is likely to be tubercular in nature and hence it is called tuberculoma. However, ancillary investigations like certain blood tests, Montoux test and x-ray chest are needed and I hope these have been done in your case. Solitary tuberculomas usually respond well to anti tubercular treatment and the treatment needs to be given for long duration of time with periodic follow up. In addition, antiepileptic drug (s) need to be given to prevent the focal seizures, which happened in your case. Repeat scan should preferably be done at 3 months to see if the lesion has disappeared or regressed.

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