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| NCCT Brain at the time of the first seizure |
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| shows left frontal hypodensity |
A 25 year old man, working as a security guard at a local medical college, was well till he was hit by a
car while walking with his bicycle; he fell to the ground and sustained mild head injury with transient loss of consciousness.
He was taken to a local hospital by the driver of the car, and a bleeding occipital scalp wound was stitched. 8 hours after
the fall the patient underwent a CT Brain.
The NCCT Brain showed edema in the right fromtal lobe and the CECT Brain showed ae enhancing lesion, which could be either
a tuberculoma or a neurocysticercosis.
The child was started on oral steroids, anti-tubercular drugs, and anti epileptics.
He underwent follow-up neuroimaging 6 weeks later which showed resolution of the edema and the lesion, and anti-tubercular
drugs were continued.
The child returned with episodes of motor speech arrest and right focal tonic clonic seizures, and was evaluated with
an EEG which showed left fronto-temporal high amplitude theta and delta activity suggestive of underlying structural lesion.
The T1 Axial MR shown below shows the return of edema in the same area in which he had the earlier lesion. A gado-enhanced
MR was done.
This article contributed by Jane Turner.
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