Intracranial tuberculoma - MRI brain
Recent onset of seizures.
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MRI demonstrates a 2cm rounded lesion in the anterior pole of the left frontal lobe. The lesion is mostly isointense to grey matter, with perhaps small regions of hyperintensity on T1 and T2 weighted images. Of note, there is no well defined central region of T2 hyperintensity. Very extensive vasogenic oedema is present extending back to the precentral region. ADC demonstrates increased values centrally, making a conventional bacterial abscess unlikely.
Following administration of contrast the lesion enhances relatively homogeneously.
The vast amount of oedema, lack of central liquefaction / restriction and knowledge of the patient's demographics (the patient lives in India) makes a tuberculoma the most likely diagnosis (subsequently confirmed).