Clinicoradiological improvement of intracranial tubercular abscess with medical management alone

Abstract

Tubercular abscess is a rare presentation of central nervous system tuberculosis (TB), which commonly presents as tuberculoma or meningitis. Most of the published cases of tubercular brain abscess have been dealt with by surgical treatment along with medical management. We here report a case of intracranial tubercular abscess in a 17-year-old girl presenting with fever, headache and right hemiparesis who showed significant clinicoradiological improvement with medical management alone. Thus, in a country like India where TB is highly endemic, TB should be considered as a possible aetiology for any intracranial lesion with radiological appearance suggestive of an abscess and surgical treatment can be kept as an option in case of neurological deficits, hydrocephalus or treatment failure.