A 29-year-old woman with a history of neurotuberculosis at the age of 18 months presented
with seizures, abnormal gait, and fluctuations of consciousness level, recovering
after anti-tuberculosis treatment. She remained asymptomatic for the next years, except
for moderate cognitive impairment. Years later, a brain magnetic resonance imaging
(MRI) scan ([Figure 1]) revealed calcified lobulated masses in the brain parenchyma and basal cisterns.
Figure 1 Magnetic resonance imaging shows multiple lobulated masses with low signal in T1-weighted
(A) and T2-weighted (B and C images in the brain parenchyma and basal cisterns, with
low signal in susceptibility-weighted imaging (SWI) (D) and phase images (E), compatible
with calcifications. Lesions are non-enhancing in post-gadolinium images (F), except
for a few peripheral enhancing foci (arrows), corresponding to small vessels.
Intracranial tuberculomas occur in 5–24% of pediatric neurotuberculosis[1] and can be secondary to pial vessel inflammation, perivascular abscesses, or septic
emboli[2]. Medical history and the characterization of non-enhancing, diffusely calcified
brain masses are important clues for diagnosing residual granulomas.
