Fevers and confusion.
Loading Stack -
0 images remaining
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.
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).