Tubercular cerebellitis, identified through an expansive process: A case report

Kaoutar Maasaoui, MD; Nizar El Bouardi, MD; Amina Hamdaoui, MD; Amal Akammar, MD; Meryem Haloua, MD; Badreeddine Alami, MD; Moulay Youssef Alaoui Lamrani, MD; Meryem Boubbou, MD; Mustapha Maaroufi, MD

Radiology Case Reports (Nov 2024)

Tubercular cerebellitis, identified through an expansive process: A case report

Kaoutar Maasaoui, MD,
Nizar El Bouardi, MD,
Amina Hamdaoui, MD,
Amal Akammar, MD,
Meryem Haloua, MD,
Badreeddine Alami, MD,
Moulay Youssef Alaoui Lamrani, MD,
Meryem Boubbou, MD,
Mustapha Maaroufi, MD

Affiliations

Kaoutar Maasaoui, MD: Corresponding author.; Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Nizar El Bouardi, MD: Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Amina Hamdaoui, MD: Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Amal Akammar, MD: Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Meryem Haloua, MD: Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Badreeddine Alami, MD: Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Moulay Youssef Alaoui Lamrani, MD: Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Meryem Boubbou, MD: Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Mustapha Maaroufi, MD: Department of Radiology and Interventional Imaging, CHU Hassan II Fez, Sidi Mohammed Ben Abdellah University, Fez, Morocco

Journal volume & issue: Vol. 19, no. 11
pp. 4788 – 4793

Abstract

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Central nervous system (CNS) tuberculosis is a postprimary form of tuberculosis with high mortality and morbidity rates, even with early diagnosis and treatment. Focal tuberculous cerebritis is extremely rare, typically occurring in patients without AIDS, and often associated with tuberculous meningitis. In endemic regions, it should be a primary consideration when encountering cerebral anomalies suggestive of granulomatous conditions. Its meningeal pseudo-tumor form poses a significant diagnostic challenge.We present the case of a 26-year-old man who arrived at the emergency room with cerebellar and pyramidal syndrome. Cerebral magnetic resonance imaging (MRI) revealed an expansive lesion in the right hemicerebellum with glove-finger edema and leptomeningeal thickening. Given the MRI findings and associated lung involvement, the diagnosis of tuberculosis was strongly suggested in our epidemiological context. Due to contraindications for lumbar puncture, high surgical risk, and strong clinical and radiological suspicion, antituberculous treatment was initiated in collaboration with neurologists and infectious disease specialists.The clinical and radiologic manifestations of CNS tuberculosis can mimic other infectious and noninfectious neurological conditions, as seen in our patient. Thus, familiarity with the imaging presentations of CNS tuberculosis among infectious disease specialists and radiologists is crucial for prompt and accurate diagnosis.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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