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NEUROIMAGE
Year : 2020  |  Volume : 68  |  Issue : 4  |  Page : 957-958

An Interesting Form of Presentation in Intracranial Tuberculosis


Department of Neurosurgery, Nobel Medical College and Teaching Hospital, Biratnagar, Nepal

Date of Web Publication26-Aug-2020

Correspondence Address:
Dr. Sunil Munakomi
Department of Neurosurgery, Nobel Medical College and Teaching Hospital, Biratnagar
Nepal
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.293474

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How to cite this article:
Munakomi S. An Interesting Form of Presentation in Intracranial Tuberculosis. Neurol India 2020;68:957-8

How to cite this URL:
Munakomi S. An Interesting Form of Presentation in Intracranial Tuberculosis. Neurol India [serial online] 2020 [cited 2020 Oct 26];68:957-8. Available from: https://www.neurologyindia.com/text.asp?2020/68/4/957/293474




An 11-year-old male child was brought to our outpatient clinic following slowly progressive headache and multiple episodes of vomiting of 1-month duration. There were no significant past medical or surgical illnesses. The child was conscious and well-oriented to time, place, and person. There were no significant neurological localizing signs. His magnetic resonance imaging (MRI) brain revealed features of a lesion with heterogeneous intensity and enhancement with a closely-associated cyst, with a fluid level within, in the frontoparietal region [Figure 1]. A differential diagnosis was made of either a pilocytic astrocytoma or a ganglioglioma. The patient underwent craniotomy and complete excision of the lesion. The cystic portion had a clear CSF like content. The lesion was well-circumscribed, firm inconsistency, and was mildly vascular. The histology report revealed the presence of several ill-formed epitheloid granulomas with few langhans giant cells with lymphoid aggregates and lymphoid follicles [Figure 2], highly suggestive of tuberculosis. The cerebral spinal fluid polymerase chain reaction for tuberculosis also came positive and thereby the patient was started on antitubercular therapy.
Figure 1: MRI brain (a) T1, (b) T2, (c) FLAIR, (d) DWI, (e) SWI and (f) Contrast sequences of the lesion

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Figure 2: Histological findings of the lesion highly suggestive of TB

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Tuberculosis is considered as a great mimicker in medicine.[1] Herein, we report images of a rare form of presentation in intracranial tuberculosis in a young child. Such a presentation has rarely been reported in the literature.[2]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Neshati H, Sheybani F, Naderi H, Sarvghad M, Soltani AK, Efterkharpoor E,et al. Diagnostic errors in tuberculous patients: A multicenter study from a developing country.J Environ Public Health 2018;2018:1975931.  Back to cited text no. 1
    
2.
Raz E, Zagzag D, Saba L, Mannelli L, Di Paolo PL, D'Ambrosio F,et al. Cyst with a mural nodule tumor of the brain. Cancer Imaging 2012;12:237-44.  Back to cited text no. 2
    


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