Intracranial tuberculomas at the Kenyatta National Hospital, Nairobi.

OBJECTIVE: To study the frequency, mode of presentation and outcome following treatment of intracranial tuberculomas. DESIGN: A retrospective study. SETTING: Kenyatta National Hospital, from January 1985 to December 1995. SUBJECTS: Thirty patients with intracranial tuberculomas. RESULTS: The male:female ratio was 1:1.1. Sixty per cent of the patients were below the age of thirty years. Twenty per cent of the patients had concomitant extracranial tuberculosis of which fifty per cent was pulmonary. The average duration of symptoms at the time of diagnosis was seven months. Headache was the commonest symptom and occurred in 70% of the patients. Seizures were seen in 37% of the patients. Nine patients had a Mantoux test done and five were positive. Twelve patients underwent serological screening for the human immunodeficiency virus (HIV) and only one was positive. Common features seen in computerised tomography (CT) scan of the head were isodense and hyperdense mass lesion with ring enhancement in 38% of the cases, associated brain oedema and mass effect. Calcification and cystic changes were rare as were hypodense changes. All the patients received anti-tuberculosis therapy. Thirty three per cent of the patients made a full recovery, one patient became debilitated, two patients died while undergoing treatment, seven patients recovered with persistent neurological deficits and eight patients were lost to follow up. CONCLUSION: Intracranial tuberculomas constituted a large proportion of intracranial tumours at the Kenyatta National Hospital during the period under study.