A Neuro-Behçet's Case Operated with the Intracranial Mass Misdiagnosis
The 25-year-old male patient diagnosed with BD three years ago was admitted to our clinic with complaints of recurrent throbbing headache accompanied by nausea and vomiting for four months. The neurological examination of the patient was normal. On the Cranial magnetic resonance imaging (MRI), a lesion that was thought to be accordant with choroiditis or a tumor with a diameter of one cm was detected near the left lateral ventricle posterior horn and near the left temporal lobe uncus (). Lumbar punction (LP) could not performed because the patient did not give permission for an LP. The patient was then discharged. On the basis of the intracranial mass (malignancy?) diagnosis, a tumor excision was made on the patient who applied at another center. The pathological examination was consistent with a definite loss of myelin in the lesion via the immuno-histochemical method. Finally, it was commented as having a demyelinating non-tumoural etiology. After the operation, intensive oedema areas were observed in the left temporo-parietal, left pons hemisphere, and left mesencephalic hemisphere on the cranial MRI (). Right hemiparesis and motor aphasia were observed and three weeks later the patient suffered from secondary generalized tonic-clonic seizures. Triple antiepileptic and 1 gr/day methyl prednisolone were given to the patient who suffered persistent seizures and lethargy. Colchicine treatment was administered for BD. The patient's seizures were kept partially under control with this treatment, and he was discharged with the recommendation of coming to the controls.