title: Isolated thalamic tuberculoma presenting as ataxic hemiparesis.
abstract: Lacunar syndrome is a neurodeficit secondary to a deep cerebral lesion, usually because of microatheroma of small arteries. Ataxic hemiparesis (AH) is a lacunar syndrome with unilateral pyramidal weakness and ipsilateral ataxia. Thalamic tuberculoma, as a cause of AH, has not been previously described in the literature. We describe an elderly man who presented with left hemiparesis and ipsilateral ataxia. Clinical examination revealed upper motor neuron left facial paresis and left-sided hemiparesis. The patient had incoordination in left upper and lower limbs. Mantoux test was positive and erythrocyte sedimentation rate was elevated. MRI of brain showed a conglomerated hypointense lesion in the right thalamus with a peripheral hyperintensity on T1-weighted imaging and a hyperintense lesion in T2-weighted imaging with significant perilesional oedema, suggesting a tuberculoma. The patient was treated with antitubercular therapy and was symptomatically better at the 9 months follow-up.
authors.affiliation: Department of Neurology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Ritesh
authors.initials: R
authors.lastname: Sahu
authors.forename: Tushar B
authors.initials: TB
authors.lastname: Patil
authors.forename: Prakash
authors.initials: P
authors.lastname: Kori
authors.forename: Rakesh
authors.initials: R
authors.lastname: Shukla
mesh_terms: D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D001259:Ataxia / Q000175:diagnosis; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010291:Paresis / Q000175:diagnosis; D013786:Thalamic Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology*; D016862:Tuberculoma, Intracranial / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents