A study of clinical profile and etiology ring enhancing lesion in CT scan brain at a tertiary care center

Abstract

Background: Confusion lies over the diagnosis when the patients show ring enhancing lesions of the brain on CT scan. Some consider it as tuberculoma while some consider it as cysticercosis. More studies are required to give clear picture of ring enhancing lesions of the brain. The objective was to study clinical profile and etiology ring enhancing lesion in CT scan brain at a tertiary care center.Methods: This study was conducted in the Department of General Medicine, SVS Medical College, Mahabubnagar district which is a tertiary care referral hospital in the state of Telangana. This study was done during the period from July 2006 to October 2008. A total of 50 cases were taken up for this study. After selecting the patients for the study, already prepared protocol was followed strictly for each patient. The protocol contained identification data, detailed history and examination of central nervous system and peripheral signs for tuberculosis and cysticercosis.Results: The males were more than the females and 14-24 years age group was most affected. The most common presentation of ring enhancing lesions was seizures alone in 72% of the cases. Out of these cases the most common presentation was generalized tonic-clonic seizure in 40% of the cases. Majority i.e. 45 had single ring enhancing lesion on CT scan of the brain. The most common etiology of the ring enhancing lesion was found out to be neurocysticercosis in 54% of the cases of ring enhancing lesions.Conclusions: Ring enhancing lesions should be considered in differential diagnosis of those who present with seizures in endemic areas like India.

Utility of Clinical and Radiological Markers in Diagnosing Cerebral Tuberculoma and Neurocysticercosis

“…Hemiparesis was reported as the most common motor deficit (80%), followed by monoparesis (20%) in a similar study by Gandhi and Khalid. 15 Abnormal fundus examination was associated with 36.20% (n ¼ 21/58) of studied participants.…”

“…The incidence of solitary and multiple lesions in the study by Gandhi and Khalid was 90 and 10%, respectively. 15 Similarly, Varma et al reported the incidence of solitary lesions to be 77.1% and multiple lesions to be 22.9%. 14 In the tuberculoma subgroup, 61.76% of patients had multiple discrete RELs, 23.52% had conglomeration, and 14.7% had single RELs.…”