Missed our latest free live-stream? Catch up now with Intracranial Enhancement by Frank Gaillard

CNS tuberculomas

Case contributed by Dr Dalia Ibrahim

Presentation

Headache and ataxia.

Patient Data

Age: 30 years
Gender: Male
MRI

Multiple (about four) space occupying lesions are seen in the right cerebellum, left frontal and right parietal parafacalcine regions. The largest lesion is in the right cerebellum. The lesions elicit isointense signal on T1 with hyperintense margins, low signal on T2/FLAIR WI. Characteristic hypointense margins on susceptibility weighted imaging are noted. On post-contrast series they show peripheral rim enhancement.

The lesions are surrounded by mild vasogenic edema.

The patient underwent surgical excision of the right cerebellar lesion which is pathologically proven case of tuberculoma. The patient received antituberculous therapy for 2 months, then presented for follow up.

MRI

Follow-up

Surgical excision of the right cerebellar space occupying lesion associated with area of encephalomalacia, gliosis and irregular linear enhancement at the operative bed, representing post-operative changes.

Regression of the size of the left frontal and right parietal lesions.

Case Discussion

This case illustrates the typical features of intra-cranial tuberculomas with characteristic low signal on T2/FLAIR WI, peripheral hypointense rim on SWI and peripheral rim enhancement post-contrast.

PlayAdd to Share

Case information

rID: 72245
Published: 13th Dec 2019
Last edited: 14th Dec 2019
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.