A rare third ventricle solitary tuberculoma.

The localization of the tuberculoma at the third ventricle is rare. The authors report a case of third ventricle solitary Tuberculoma which has occurred in a 10 year old patient and revealed by a syndrome of intracranial hypertension without tuberculosis stigma. This lesion appears clinically and radiologically as a primary brain tumor. A total removal using a subchoroidal approach to the third ventricle has been performed. Histological examination showed a tuberculous like granuloma. An adjuvant antituberculous chemotherapy practiced for 6 months brought the complete cure. The authors insist on the diagnostic and therapeutic difficulties in front of a third ventricle solitary tuberculoma.

Endoscopy for tuberculous hydrocephalus.

INTRODUCTION: The role of endoscopy in hydrocephalus due to infectious aetiology is unclear. Tuberculous hydrocephalus is a useful model to study because it presents particular challenges and the pathophysiology of the cerebrospinal fluid disturbance is well known. MATERIALS AND METHODS: We present the results of 24 endoscopic operations in tuberculous meningitis. RESULT: Endoscopic third ventriculostomy (ETV) was attempted in 17 patients: seven were successful, five failed, and five were not completed due to abnormal anatomy. There were five fenestration procedures, three of which were successful. Endoscopic biopsy of two tuberculomas failed to yield a bacteriological result. These operations were more difficult to perform than for hydrocephalus due to other aetiologies. CONCLUSION: Although ETV is technically possible in this situation, it is imperative that the patients are adequately selected for the procedure to ensure optimal treatment and that the surgeon has experience with difficult cases.