“Uninvited guests” of the brain in a 19th-century museum

Infectious diseases of the central nervous system (CNS) remain an important cause of morbidity and mortality worldwide [1]. They vary according to region and population characteristics. Yet, despite health care improvements, they often are under or misdiagnosed. One measure to ameliorate diagnosis may be to sensitize young medical generations to the problem, namely by promoting the observation and study of affected CNS specimens during the under and postgraduate medical curriculum. Since in most countries autopsy rate has decreased, Anatomopathological Museums may be an alternative resource [2]. At the Faculty of Medicine of Coimbra’s University (FMUC), the Anatomopathological Museum – founded in 1822 – contains 22 liquid-preserved brain specimens displaying infeccious lesions due to bacteria (Meningococcus spp, Streptococcus pneumonia, Treponema pallidum, Mycobacterium tuberculosis). The authors show one of the specimens with a tuberculoma (Fig. 1A, B). In fact, tuberculosis remains a Public Health issue throughout the world and not only neurotuberculosis ranges 1% of active tuberculosis [3], but also tuberculomas present as a differential diagnosis among CNS space-occupying lesions. To conclude, we highlight the relevance of Anatomopathological Museums as a medical – namely neuropathological – teaching tool.

Acknowledgements

To Instituto de Anatomia Patológica (IAP), Faculdade de Medicina – Universidade de Coimbra (FMUC).

The authors declare no conflict of interest.

References

1. Peidaee E, Sheybani F, Naderi H, et al. The Etiological Spectrum of Febrile Encephalopathy in Adult Patients: A Cross-Sectional Study from a Developing Country. Emergency Medicine International 2018; ID 3587014: 1-8.
2. Gulczyński J, Paluchowski P, Halasz J, et al. An Insight into the History of Anatomopathological Museums. Part 2. Pol J Pathol 2018; 69: 118-127.
3. Kheir AEM, Ibraim SA, Hamed AA, et al. Brain tuberculoma, an unusual cause of stroke in a child with trisomy 21: a case report. J Med Case Rep 2017; 11: 114.

Address for correspondence

Prof. Rosa Henriques de Gouveia
Forensic Pathology, Central Branch
Instituto Nacional de Medicina Legal e Ciências Forenses, I.P.
Largo da Sé Nova
3000-213 Coimbra, Portugal