CT of multiple intracranial cryptococcoma.

A case of intracranial cryptococcal masses was encoun­ tered with an unusual computed tomographic (CT) demon­ stration of multiple enhancing deep cortical , basal ganglionic, and posterior fossa lesions which were difficult to differentiate from metastatic disease. Although there have been a few previous reports [1-6] of intracerebral cryptococcal granu­ lomas and abscesses with correlative CT scans, this case may be unique in the number and location of the intracranial cryptococcal mass lesion s. Case Report A 57-year-old had occipital headaches and difficulty in walking ; he fe ll frequently. His family gave a history of heavy alcohol consumption and confusion and dementia for several months. Physical examination revealed a cachectic and unkempt elderly man who was lethargic but followed commands well . He was afebrile and other vital signs were stable. His neck was supple and his chest was clear. He was oriented to person and place, but not to time. Both recent and remote memory were poor. Cranial nerves were intact, and there was no papilledema. Deep tendon reflexes were 2+ and symmetric with fiexor plantar reflexes. He had a wide-based gait. A lumbar puncture at admission revealed clear cerebrospinal fluid (CSF) with an opening pressure of 42 cm of water, a white blood cell count of 72/mm 3