{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T04:40:29Z","timestamp":1772080829318,"version":"3.50.1"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T00:00:00Z","timestamp":1663027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Multiple brain tuberculomas (MBT), characterized by disseminated tuberculous granulomas in the brain, is a rare disease like tuberculosis encountered after <jats:italic>in vitro<\/jats:italic> fertilization, embryo transfer (IVF-ET), and abortion. This study aimed to investigate the clinical characteristics, diagnostic methods, and therapeutic strategies of MBT after IVF-ET and abortion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was performed on the data of two patients who suffered from MBT after IVF-ET and abortion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both patients manifested headache and vomiting, which are the common symptoms of intracranial hypertension, accompanied by tuberculous meningitis. Besides, case 1 was affected by fever and epilepsy. In terms of imaging characteristics, T2-weighted imaging (T2WI) displayed multiple intracranial punctate or patchy high-intensity signals, some of which were presented as \u201ctarget sign\u201d or enhanced-like disseminated nodules, similar to miliary tuberculosis. Regular anti-tuberculosis therapy with isoniazid, rifampicin, pyrazinamide, and ethambutol was administered but failed to achieve a significant effect in the initial stage. The symptoms were gradually relieved, and the brain lesions in MRI were significantly alleviated after combining with intrathecal injections of isoniazid, dexamethasone, and chymotrypsin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:italic>In vitro<\/jats:italic> fertilization, embryo transfer (IVF-ET) may be a risk factor for MBT, the common manifestations of which are intracranial hypertension. In addition to multiple nodular enhancement on brain MRI, the \u201ctarget sign\u201d on T2WI is likely to be another typical feature of MBT. Provided that there is no obvious effect of regular anti-tuberculosis therapy (ATT), intrathecal injections of isoniazid, dexamethasone, and chymotrypsin are considered to produce a favorable prognosis, but further studies are still needed to confirm the efficacy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.971373","type":"journal-article","created":{"date-parts":[[2022,9,13]],"date-time":"2022-09-13T07:39:03Z","timestamp":1663054743000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Case report: Multiple brain tuberculomas after in vitro fertilization, embryo transfer, and abortion"],"prefix":"10.3389","volume":"13","author":[{"given":"Zhaobo","family":"Shi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1080\/07853890.2021.2018485","article-title":"Clinical analysis of pregnancy complicated with miliary tuberculosis","volume":"54","author":"Wang","year":"2022","journal-title":"Ann Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.ijgo.2011.10.034","article-title":"The effect of tuberculosis on ovarian reserve among women undergoing IVF in India","volume":"117","author":"Malhotra","year":"2012","journal-title":"Int J Gynecol Obstet."},{"key":"B3","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1111\/bpa.12590","article-title":"A 27-year-old female with multiple intracranial lesions","volume":"28","author":"Al-Hussaini","year":"2018","journal-title":"Brain Pathol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"231","DOI":"10.7883\/yoken.JJID.2015.104","article-title":"A clinical study of miliary brain tuberculomas in China","volume":"69","author":"Yang","year":"2016","journal-title":"Jpn J Infect Dis."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e236","DOI":"10.1016\/j.wneu.2019.01.053","article-title":"Factors predicting the need for prolonged (>24 months) antituberculous treatment in patients with brain tuberculomas","volume":"125","author":"Nair","year":"2019","journal-title":"World Neurosurg."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1532","DOI":"10.1093\/cid\/cis732","article-title":"Tuberculosis in pregnant and postpartum women: epidemiology, management, and research gaps","volume":"55","author":"Mathad","year":"2012","journal-title":"Clin Infect Dis."},{"key":"B7","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/j.ejogrb.2016.12.009","article-title":"Multi drug resistant female genital tuberculosis: a preliminary report","volume":"210","author":"Sharma","year":"2017","journal-title":"Eur J Obstet Gynecol Reprod Biol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1111\/jon.12627","article-title":"Neuroimaging findings in tuberculosis: a single-center experience in 559 cases","volume":"29","author":"Azeemuddin","year":"2019","journal-title":"J Neuroimaging."},{"key":"B9","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1016\/j.jemermed.2007.10.060","article-title":"Intracranial tuberculomas: an unusual cause of altered mental status in a pediatric patient","volume":"38","author":"Krygowski","year":"2010","journal-title":"J Emerg Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"181","DOI":"10.3390\/idr13010020","article-title":"Intracranial tuberculoma mimicking neurosarcoidosis: a clinical challenge","volume":"13","author":"Abbasi","year":"2021","journal-title":"Infect Dis Rep."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1527","DOI":"10.1056\/NEJMicm1103165","article-title":"Images in clinical medicine. 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