Dr. Shajitha Parveen H, Dr. R. Malarvizhi, Dr. M R Chitra
A 14-year old female, came with history of frontal headache, vomiting and binocular diplopia for 10 days. With no significant past history, general and systemic examinations were normal. Visual acuity was OD 6/9 and OS 6/9. Anterior segment was normal in both eyes. Fundus showed bilateral papilledema. Mild restriction of abduction was noted in both eyes suggesting bilateral VI nerve palsy. Other cranial nerves were normal. Automated perimetry showed a right homonymous hemianopia with macular sparing in both eyes. Routine blood tests showed raised ESR. MRI brain revealed T1(iso-) T2(hypo-intense) intra-axial nodular cystic lesion with peripheral ring enhancement (contrast) in left occipital lobe, suggesting a tuberculoma. Chest X-ray was normal. Mantoux was negative. Quantiferon TB gold test was positive. With category I ATT, improvement in extra ocular movements, disc edema and visual fields were noted after 3 weeks.