Isolated Cerebellar Tuberculoma

A 10-year-old boy presented with an 8 day history of intermittent headache, progressive loss of vision, and gait ataxia. Therewas no history of fever, vomiting, or seizures. He had normal cognition, bilateral optic disc edema, and cerebellar dysfunction. His elder sister had sputum positive for tuberculosis. Mantoux was 16 mm; erythrocyte sedimentation rate was 64 at 1 hour. Magnetic resonance imaging of the brain revealed multiple conglomerated ring-enhancing lesions in right cerebellum, basal exudates, hydrocephalus, and tonsillar herniation (Fig).