Q: My wife had severe headache, vomiting, vision problem and dizziness from last 6-7 months. She also suffered from high blood pressure in the range 160/110 and used to take Betaloc 50mg. Her reports are as follows:
Impression of MRI scan of brain - Irregular enhancing lesions in right cerebellum with perilesional edema, mass effect over brain stem and obstructive hydrocephalus - ? Tuberculosis.
MRI scan of Cervical Spine - Bulge of C5-C6 disc indenting thecal sac but not causing remarkable spinal or neural foraminal stenosis.
Impression of CT scan of brain - an irregular mixed attenuating heterogeneously enhancing SOL with perilesional oedema causing compression of fourth ventricle & dilatation of supratentorial ventricles. Nature (?): possibilities are 1. Tuberculoma 2. Glioma.
Mantoux test: negative.
My wife got operated on right cerebellum in National Neurosciences Centre, Kolkata.
Impression of biopsy from right cerebellum - Necrotising granulomatous inflammation consistent with tuberculosis, right cerebellum.
Present state: She has been discharged from hospital and advised bed rest. She doesn't complain about the headache. But has some movement pain below the chest area. Was the treatment right? If at all the brain was affected by tuberculosis, was the operation of right cerebellum necessary? What may be the cause of the infection in brain? Will it affect our 2 and half year old daughter? Will it affect our marriage? Does tension play any role in such a situation? Following medicines have been advised-
a) R-Cinex (600 mg)-daily once
b) P-Zide (750 mg)- daily twice
c) Tab Zofer(4 mg)- daily thrice
d) Injection Streptomycin (.75 gm)- daily once
e) Espra (40 mg)- daily once.
f) Benadon (40 mg)- daily once.
No BP medicines advised.
Doctor has advised for LFT within two months. Should we follow his advice?
A:The best thing in her case is operation and full medical treatment as given. Surgery was necessary. TB is very common in our country and 85% have the infection and usually are able to control it. Sometimes it may escape the body's defences and then phase up. TB in the brain is not infective to people around. I am sure a chest x-ray of your wife has been done. Only TB lungs is infective to others. There will be no effect on your marital relations. Tension plays no significant part in its aetiology.