Presentation
Headache, fever, and progressive alteration of the state of consciousness in two weeks.
Patient Data
There is slight dilation of the temporal horns and subtle dilation of the third ventricle.
Following administration of contrast, the presence of leptomeningeal contrast enhancement predominantly in the basilar cisterns with the presence of more nodular components suggestive of multiple granulomas.
Case Discussion
The findings are suggestive of basal meningitis associated with mild hydrocephalus. Basal contrast enhancement is not pathognomonic of tuberculous meningitis; it needs to be associated with the clinical manifestations, previous history, and epidemiological aspects (especially in endemic regions like South America, Eastern Europe, Africa, and Asia).