Image Report
doi:
10.25259/SNI_206_2020
“Crown and necklace” appearance of cisternal tuberculoma
Department of Neurosurgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.
*Corresponding author: Ahmed Ansari, Department of Neurosurgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah - 206130, Uttar Pradesh, India. ahmed.ansari2@gmail.com
-
Received: ,
Accepted: ,
Copyright: © 2020 Surgical Neurology International
How to cite this article: Ansari A. “Crown and necklace” appearance of cisternal tuberculoma. Surg Neurol Int 2020;11:135.
We report a case of a 35-year-old female with features of headache and evening rise of temperature. She was found neurologically intact on examination. Contrast-enhanced MRI brain (axial and coronal) [Figures 1 and 2] showed multiple ring-enhancing lesions in the suprasellar and interpeduncular cisterns (crown appearance), and ambient and perimesencephalic cisterns (necklace appearance). Blood counts suggested a rise in lymphocytes with positive gamma interferon for tuberculosis. The patient was advised antitubercular treatment and was lost in follow-up after 3 months.

Figure 1::
Axial magnetic resonance imaging showing ring-enhancing lesions in cisterns giving “crown and necklace” appearance.

Figure 2::
Coronal magnetic resonance imaging with multiple tuberculomas in suprasellar cisterns.