Neurology India Medknow Publications on behalf of the Neurological Society of India ISSN: 0028-3886 EISSN: 1998-4022 Vol. 50, Num. 3, 2002, pp. 379

Neurology India, Vol. 50, No. 3, Sept, 2002, pp. 377-378

Neuroimage

Targetting the Tuberculoma

P.S. Kharbanda, S.K. Handa, S. Prabhakar

Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012, India.

Code Number: ni02110

A 17 years female, an old case of systemic lupus erythematosis (SLE), with nephropathy, who had been on immunosuppression, presented with weakness of left upper and lower limbs for the past two months. The left plantar showed extensor response. Patient also had altered sensorium and headache of one month duration. Cerebrospinal fluid (CSF) showed adenosinedeaminase (ADA) value of 12 U/L, leukocyte count of 160/cumm with 90% lymphocytes and 10% polymorphs. CSF proteins were 210 mg% and glucose 64%. MRI revealed multiple conglomerate lesions in the midbrain (Fig. 1) and basal ganglia (Fig. 2), which were enhancing on contrast. The image of interest is a noncontrast coronal MRI section, which showed a very peculiar target like lesions with central dot and multiple hypo and hyperintense peripheral rings (Fig. 3). A diagnosis of tubercular meningitis with multiple tuberculomas was made. The patient was started on antitubercular therapy.

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