Presentation
Patient admitted with reduced conscious level. No known history of TB.
Patient Data
Admission CT head was normal. Rpt CT after GCS drop shown.
Intense symmetrical nodular enhancement of the leptomeninges overlying the tentorium, with vivid illustration of the cerebellar folia.
No thickening or enhancement of the basal cisterns.
Moderate biventricular hydrocephalus with minor transependymal edema.
Diffuse high signal change in the cerebellar vermis and anterioinferiorly in both cerebellar hemispheres.
Intense symmetrical nodular enhancement of the leptomeninges overlying the tentorium.
No thickening or enhancement of the basal cisterns.
Moderate biventricular hydrocephalus with minor transependymal edema.
Case Discussion
Lumbar puncture was performed which was interpreted as being suggestive of possible TB, but negative for AFFB.
AFFB positive sputum. Chest x-ray suggestive of prior TB.
Extensive investigation for a tumor was undertaken which was negative.
The patient was treated for TB.
Cerebral TB may manifest itself in a number of ways including cerebral leptomeningitis and cerebral abscess.
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