Presentation
6 months history of fever, weight loss, cough. He progresses with neurological symptoms, seizures and a poor response to antifungals.
Patient Data
Supratentorial and infratentorial, extra-axial masses located at the level of the temporal horn of the right lateral ventricle, prepontine cistern and pontocerebellar angle, as well as in straight gyrus region, which are irregular in morphology, lobulated edges, hypointense on T1, isointense to the gray matter on T2 and FLAIR, with diffusion restriction and areas of susceptibility artifact on gradient echo sequence. After gadolinium administration, they present ring enhancement with hypointense central areas. As well as patchy and leptomeningeal enhancement with discrete perilesional vasogenic edema.
Case Discussion
This is a patient with a tuberculosis diagnosis confirmed by bacilloscopy who, when manifesting neurological symptoms, was a candidate for an imaging study. Tuberculomas are a complication of primary tuberculosis infection. In this case, findings of tuberculomas are observed, in addition to a pathological enhancement of the meninges, which extends to the cervical medullary canal, consistent with tuberculous meningitis.
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