Tuberculous meningitis

Case contributed by Dr Amro Omar

Presentation

Fevers and confusion.

Patient Data

Age: 29
Gender: Female
Modality: MRI

Nodular meningeal enhancement is seen, more basal in location (best seen in the sagittal views). Please note the multiple parenchymal lesions (tuberculomas), most noted in the left posterior fossa. Diffusion restriction is also present.

Also note early signs of communicating hydrocephalus.

Case Discussion

The combination of meningitis and parenchymal lesions suggested TB in a patient with no suspected malignancy. This case was proved by lumbar puncture. 

CNS tuberculosis is commonly secondary to hematogeneous spread (often pulmonary).

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Case Information

rID: 34106
Case created: 4th Feb 2015
Last edited: 1st Oct 2015
Inclusion in quiz mode: Included

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