FINDINGS Figures 31-1 and 31-2. Axial DWI with corresponding ADC map. There is ring-restricted diffusion in the splenium of the corpus callosum (CC) (arrows). There is surrounding increased diffusion consistent with vasogenic edema. Figure 31-3. Axial FLAIR through the splenium of the CC. There is smudgy hyperintensity through the splenium of the CC surrounding a hyperintense ring with hypointense core (vertical arrow). There is an additional ring hyperintensity in the adjacent left occipital lobe with a hypointense core (posterior transverse arrow) and in the parafalcine left frontal lobe (anterior transverse arrow). Figure 31-4. Axial post-contrast T1WI through the splenium just superior to Figure 31-3. There are two adjacent ring contrast enhancing lesions in the splenium on the left with hypo/isointense core (arrow) and other ring-enhancing cortical lesions elsewhere in the brain (transverse arrows). These also have isointense core.
DIFFERENTIAL DIAGNOSIS Tuberculomas (TBs), metastasis, pyogenic abscess, fungal infection, neurocysticercosis.
DIAGNOSIS CC TB.
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