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Space-occupying lesions of the brain

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dear Doctor,

6 months later my daughter has been diagnose with brainstem glioma
she have only double vision,and receive 31 sessions of radiotherapy.
after 4 months and after taking decadron for 2 months
her situation deteriorate and after more investigation the final
diagnose was brainstem tuberculoma.
she take antituberculoma drugs (4 week ago)

can receiving radiotherapy on brainstem tuberculoma cause
her deterioration ??

can radiotherapy and decadron for 2 months show NO improvement
at all so they more investigate and the final diagnose was tuberculoma ???

after my daughter deterioration for 7 days ( she cannot talk, walk, swallow )now she can talk ( 20% ),eat ( 50 % ) and walk ( 10% ).

can this improvement be possible on brainstem glioma?? or because she
take antitubeculoma drugs.

the lesion is approx. 3 cm, how long the antituberculoma drug take
to show some improvement ??

thanks and regards

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replied November 25th, 2009
Neurological Disorders Answer A7998
I am very sorry to read of your daughter's health condition. Any mass or space occupying a lesion in the brain can cause visual problems by increasing the pressure in the head, which results in damage to cranial nerves (III, IV and VI) responsible for the eye movements.

Your daughter's medical history (swallowing and walking difficulties) suggests that she may have a space-occupying lesion in the brainstem area. Brainstem gliomas are rare but can be found in children not uncommonly. Any lesion in the brain stem can produce similar symptoms. It is not possible to say whether it was glioma or tuberculoma with certainty without the access to reports of investigations like MRIs and other investigations like CSF analysis, Mantoux or tuberculin test, etc. Did she have a vaccination (BCG) against Tuberculosis?

Tuberculosis can produce mass lesions in the brain and can cause symptoms of headache, loss of weight, double vision and symptoms related to motor functions. Tuberculous masses respond very well to anti-tuberculous treatment, which may be required up to 9 months. The recovery depends on the size of the lesion, extent of the damage already occurred. A 3 Cm lesion is of considerable size and will take time to regress and respond.

Naturally, your daughter needs to be treated in liaison with the neurologist. Hope this information helps you.

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