Figure 1: This is an MRI brain that shows a lesion with vasogenic oedema in the right fronto-pareital region (A), and after IV Gad contrast, it shows lesion with leptomeningeal enhancement of both cerebral hemispheres (B and C).

A previous healthy 7-year-old boy comes at the neurology out-patient department with right side hemiparesis, altered of speech,and seizure for six months. No previous history of Tuberculosis or other chronic diseases. Physical examination, he was afebrile and no meningeal signs, there was right side weakness (power 3/5). Magnetic resonance imaging of the head with intravenous gadolinium showed ring contrast enhancement on post-contrast images was observed. Widespread vasogenic edema was observed around this described lesion (Figue 1: A). A shift reaching 18 mm to the right in the midline of the brain was observed. In addition, leptomeningeal enhancement areas were detected in both cerebral hemispheres. Findings are highly compatible with intracranial tuberculoma and accompanying meningitis (Figure 1: B and C), and the HIV test was negative. Resection was planned and performed. Histological findings showed caseous necrosis with giant multinucleated cell of Acid Fast Bacillae. The patient was started with 1 year of ant-tubercle treatment. His symptoms improved. Tuberculoma and TB meningitis are two of the devastating complications of TB, which require prolonged treatment and have a poor prognosis [1,2,3].

Author Contribution: The author has been fully contributed and approved for the final draft.

Conflict of interest: The author has no any conflict of interest to report.

Consent: A written informed consent was obtained for the patient’s father to publish this image report.

Funding: No funding is avalibale.

Reference