Existing comment:
Tuberculomas:
Man: 35 years
Admitted: January 1928
Died: March 1928
Diagnosis: Psychosis, not differentiated.
He complained of blindness upon admission, but seemed to be able to find his way about the ward. There was a history suggestive of drinking wood-alcohol. He had delusions that a society was trying to get him out of the way, because of his beautiful wife. He was very weak. Had spells in which he would fall out of his chair.
Examination disclosed emation, fever, great weakness. A diagnosis of pulmonary tuberculosis was confirmed by X-ray. Sputum was negative. He became stuporous, had stiffness of the neck & bilateral reflex-grasping. Spinal puncture showed increased pressure, 19 cells and a meningitic gold curve. Pupils were inactive. The optic disks were normal. The Wasserman reaction was negative. A diagnosis of tuberculous meningitis was made.
Necropsy disclosed generalized miliary tuberculosis, no meningitis. There were older lesions of tuberculosis in adrenals and brain.
The specimen shows a large, conglomerate tubercle, high up in the left frontal lobe with implantations in the adjacent right frontal lobe. The ventricles are narrowed and displaced downward. The surrounding tissue is a little soft and broken up.
In the cerebellum is another tuberculoma. The characteristic lobulation and lamellation are well shown. |