PATHOLOGICAL ANALYSIS OF INTRACRANIAL SPACE-OCCUPYING LESIONS IN 1000 CASES INCLUDING CHILDREN .1. AGE SEX AND PATTERN - AND TUBERCULOMAS

1. (1) 1000 intracranial space-occupying lesions (ICSOL) were analysed and compared with other series reported from different parts of the world. Of these 881 were biopsy specimens. 2. (2) 252 were from children under 15 years. In contrast to the paediatric neoplasms in Zulch's (1957) series which constitute only 8% of the total, a higher proportion was observed in the present series (16.8% of the neoplasms). 3. (3) The average age for all the ICSOL was found to be 27.1 years and for neoplasms 30.9 years, which is nearly a decade lower than that found in Zulch's series. 4. (4) 21.5% of all ICSOL and 46.4% of ICSOL in children were tuberculomas. The percentages for all tumour entities were calculated separately for 1000 ICSOL and for 768 neoplasms. On the basis of the total, the percentage for most brain tumours was much lower than the figures given in other series from countries where the incidence of tuberculoma is very low. When the neoplasms alone were considered, the percentages of all tumour entities reached a level comparable to that reported by others. This difference became more evident in paediatric material, where, for instance, the percentage of gliomas went up from 40.1% of total ICSOL to 78.3% of true neoplasms. 5. (5) The low average age of ICSOL (27.1 years) was partly due to the inclusion of tuberculomas. They were also responsible for the high proportion (20%) of ICSOL in the first decade. Their presence had raised the proportion of infratentorial lesions from under 33% in neoplasms to over 37% in ICSOL, and had lowered the male preponderance from 67% in neoplasms to 62% in ICSOL. 6. (6) 56.5% of all tuberculomas were in females, but in the first decade of life 59% of affected individuals were male; the preponderance of the female sex was manifested from the 2nd decade onwards, especially after puberty. 7. (7) The histological features of tuberculoma including those of the rare cystic change and abscess are discussed. Other unusual tuberculous space-occupying lesions are mentioned. 8. (8) The presence or absence of a correlation between the incidence of tuberculoma and that of tuberculous meningitis is pointed out. 9. (9) The other granulomas (gumma and fungal granuloma), constituting only 0.5% of ICSOL, are described briefly. 10. (10) A high incidence (1.2%) of non-neoplastic cysts was noted. 11. (11) A comparatively low incidence of meningiomas (13.1% of neoplasms) was observed, but parenchymal vasoformative tumours seemed proportionately high (5.1% of neoplasms). 12. (12) The gliomas, Schwannomas, pituitary adenomas and congenital tumours which constituted 48.2%, 9.9%, 8.7% and 7.7% of neoplasms respectively, were comparable to those in other series. 13. (13) Unusual skull tumours constituted 0.65% of all neoplasms. 14. (14) When the autopsy specimens alone (119) were considered, the metastatic lesions formed about 11%, while of the entire series they comprised only 5.2%. © 1968.