Intracranial tuberculomas

Discussion:

The imaging features, particularly in an endemic area, are almost certainly those of tuberculomas, particularly in view of the T2 hypointense centers.  The differential diagnosis includes neurocysticercosis, however, points that favor the diagnosis of tuberculoma are:

  • no obvious scolex is seen in any of the lesions
  • T2 hypointense core
  • leptomeningeal enhancement
  • presence of conglomerate lesions
  • lipid-lactate peak on MRS
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