Tuberculous meningitis with cytotoxic lesion of the corpus callosum (CLOCCs)

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Headaches, low-grade fever, and visual hallucinations.

Patient Data

Age: 30 years
Gender: Male

The MRI sequences demonstrate:

  • a small well-defined ovoid lesion in the midline within the splenium of the corpus callosum, of intermediate signal on T1, high signal on T2, and FLAIR with no enhancement and restricted diffusion on DWI/ADC in keeping with a cytotoxic lesion.
  • prominent leptomeningeal enhancement well-visualized on postcontrast T1WI and T2 FLAIR fat saturation sequences.

Case Discussion

The patient went on to have a lumbar puncture with CSF analysis which was in favor of tuberculous origin.

The cytotoxic lesion of the corpus callosum (CLOCCs) can occur with a large number of different etiologies including tuberculous meningitis. 

 

Additional contributor: A. Ramdani, MD

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