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Images in Neurology | July 2007

Multiple Parenchymal Tuberculomas Without Tuberculous Meningitis

Mill Etienne, MD; James M. Noble, MD

Arch Neurol. 2007;64(7):1045-1047. doi:10.1001/archneur.64.7.1045.

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A 56-year-old lifelong Manhattan (New York City, New York) resident presented with 4 months of bifrontal recumbent headaches, 3 weeks of morning emesis, and 2 weeks of photophobia and vertigo. For her initial headaches, she had unremarkable findings on a noncontrast computed tomographic scan of the brain. Four months before presentation, she had a 6-week hospitalization for myocardial infarction complicated by ventricular tachycardia and a 36-kg weight loss; her weight remained at 81 kg thereafter. She had no cough, constitutional symptoms, identifiable human immunodeficiency virus risk factors, or tuberculosis exposures.

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Figure 1.

Magnetic resonance image (MRI) of the brain, axial views. A, Admission MRI. B, The MRI after 9 months of antitubercular therapy. A and B: at left, noncontrast T1-weighted image; middle, postgadolinium T1-weighted image; and at right, T2-weighted fluid-attenuated inversion recovery (FLAIR). The left pontine lesion (arrowhead) correlated with facial paresis.

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Figure 2.

Magnetic resonance image (MRI) of the brain, axial views. A, Admission MRI. B, The MRI after 9 months of antitubercular therapy. A and B: at left, noncontrast T1-weighted image; middle, postgadolinium T1-weighted image; and at right, T2-weighted fluid-attenuated inversion recovery (FLAIR). There were numerous parenchymal gadolinium-enhancing lesions with associated edema (arrowheads marking one such lesion). After treatment, a single FLAIR bright signal remained (arrow).

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit^TM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 Credit^TM.

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Etienne M, Noble JM. Multiple Parenchymal Tuberculomas Without Tuberculous Meningitis. Arch Neurol. 2007;64(7):1045-1047. doi:10.1001/archneur.64.7.1045.

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