[Surgically treated XXXX of the brain. Computerized tomography findings].

@entity1 @entity2803 @entity410 @entity49751 @entity5 @entity39 @entity114 @entity3468 @entity5922 @entity1200
@entity49751 is now exceptional. Symptomatology is non-specific and frequently, as in the case reported here, the onset is marked by a localized or generalized @entity410 . A space-occupying lesion is recognized by angiography and CT. The precise diagnosis is suggested by evidence of @entity3468 or of a hypodense mass outlined by contrast or slight calcifications and confirmed by positive serology in a @entity1 with a suspected @entity5 . In some cases a positive diagnosis can be made only by pathological examination after surgical ablation of the gumma. An area of central @entity39 is surrounded by a granulomatous layer rich in plasmocytes (the polyclonal nature of the secretion is shown by immunocytochemistry) and a peripheral fibroblastic zone. The arteries are ensheathed by a dense inflammatory infiltrate constituted almost entirely by plasmocytes and their lumens are either stenosed or filled with @entity5922 . Surgical treatment should be combined with @entity114 administration. For a @entity1 in good general condition with a suspected gumma, medical treatment can be given initially, with follow-up by CT, neurosurgery being indicated only in case of failure of medical therapy. The rarity of gummata in relation to other tertiary syphilitic lesions remains unexplained. The @entity1 reported here had multiple infections including one due to @entity2803 after ablation of the gumma, highly suggesting an @entity1200 .
