Clinical Research of Intracranial Rodular Lesions on Brain CT Scan in Children.

Park, Hyeon Seon; Choi, Joong Uhn

Original Article

Journal of Korean Neurosurgical Society 1989;18(4): 562-570.

Department of Neurosurgery, Yonsei University college of Medicine, Seoul, Korea.

ABSTRACT

To make guideline to the diagnosis and treatment and of the intracranial nodular lesions, the authors made a clinical analysis on 81 pediatric patients who had showed nodular lesions on brain CT scan at Severance Hospital from Mar. 1979 to Feb. 1989 and the results were summarized as follows. 1) The peak incidence of intracranial nodular lesions was found in the 2nd decade(61.7%). There was no sexual difference. 2) The most common clinical symptom was seizure(92.6%) and the predilection site was parietal area. The nodular enhancing type on brain CT scan showed not only the most common type but also the most favorable clinical course. 3) As the etiology of the intracranial nodular lesions, tuberculosis, paragonimiasis, cysticercosis, tumor(meningioma), and aspergillosis were confirmed or suspected, but tuberculosis was the most common. CSF routine examination, chest PA, PNS X-rays, skin test for paragonimiasis and tuberculosis, CSF ELISA test for cysticercosis and paragonimiasis should be routine as the diagnostic studies. 4) We made treatment principle for intracranial nodular lesions. In cases that initial brain CT scan show low density or calcified density without contrast enhancement, we treat those patients with anticonvulsants and steroid with regular check-up. If the lesion increases in size or new enhancement develops on follow up CTY scan, medications for the suspected etiology should be added. In cases that initial brain CT scan show enhancing lesions, treatment is started with anticonvulsants and medications for the etiology with regular check up. If the lesion increase in size on follow up CT scan or seizure is uncontrolled. Surgery should be considered.

Key Words: Intracranial nodular lesion; Intracranial granuloma; Seizure; Nodular enhancing lesion; Tuberculosis; Paragonimiasis; Cysticercosis; Aspergillosis; Meningioma