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Tuberculous ventriculitis

Case contributed by Fazel Rahman Faizi
Diagnosis almost certain

Presentation

Deterioration of mental status.

Patient Data

Age: 14 years
Gender: Female
mri

Diffuse ependymal enhancement with mild dilatation of the ventricular system is noted. Leptomeningeal enhancement is also noted along with the basal cisterns, occipital lobes, and posterior fossa.

Abnormal focal signal intensities are noted involving the bilateral periventricular deep white matter and basal ganglia, returning low signal intensity on T1, high signal intensity on T2 with surrounding high FLAIR signal intensities. Foci of blooming artifacts are noted within some of these abnormal signal intensities which may represent calcification/hemorrhage. No diffusion restriction or abnormal enhancement of these foci is noted. These foci most likely represent sequela of previous insult.

A note is made of right-sided nasal septal deviation.

Case Discussion

Tuberculous ventriculitis is a rare complication of the central nervous system tuberculosis. This is a known case of central nervous system tuberculosis. The patient had been under treatment for tuberculosis infection when there was a sudden deterioration of the mental status.

Dr. Farhad Farzam has also contributed to this case.

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