A Case of Diffuse Leptomeningeal Glioneuronal Tumor Misdiagnosed as Chronic Tuberculous Meningitis without Brain Biopsy

Figure 1

Magnetic resonance imaging (MRI) findings of communicating hydrocephalus and leptomeningeal enhancement in the basal cistern at the time of initial manifestation of mental confusion (2012).

(a) A T2-weighted axial MRI image showing marked dilation of lateral and third ventricles indicating nonobstructive hydrocephalus

(b) A T1-weighted enhanced axial MRI image showing leptomeningeal enhancement (arrows) in the basal cisterns

(c) Prominent leptomeningeal enhancement is noted in the basal, interhemispheric, and left sylvian cisterns in an enhanced T1-weighted axial MRI image at the time of recurrent mental confusion (January 2017). No intra-axial enhancing lesion is observed

(d) Marked aggravation of leptomeningeal enhancement in the basal, interhemispheric, and left sylvian cisterns in an enhanced T1-weighted axial MRI image in August 2017

(e) Multiple leptomeningeal enhancing nodules along the whole spinal cord in a sagittal, fat suppressed, enhanced T1-weighted image. Indentation of the spinal cord is shown in some leptomeningeal nodules