Weber’s syndrome in an HIV positive patient: Revisiting the concentric and eccentric target signs – Question paper

•To consider differential diagnosis for multiple ring enhancing lesions in an immunocompromised patient.•To highlight the characteristic imaging features of toxoplasmosis: ‘‘concentric and eccentric target signs’’.•To radiologically demonstrate intracranial course oculomotor nerve its nucleus.•To lay stress on rare causes Weber’s syndrome: Cerebral toxoplasmosis our case. A 25-year-old male, HIV positive patient was brought to emergency with altered sensorium, left sided diplopia right motor weakness. No other co-morbidities were elicited clinical history examination. suspicion syndrome initially suggested. Ophthalmological examination revealed complete palsy. Blood investigations a CD4 count 125 cells/mm3. (Normal range: 500–1500 cells/mm3). Non-Contrast CT head normal. MRI brain T2/FLAIR hyperintense involving grey white matter junction, midbrain, bilateral basal ganglia, thalamus stem (Fig. 1), few these showing alternate hyper hypointense zones, consistent ‘concentric sign’ (Fig . 2(A-C)). diffusion restriction seen. Post contrast T1 weighted (T1W1) images nodular mural nodule within ring, ‘eccentric 2(D-F)).Fig. 2(A-C): Axial T2 involvement cerebral peduncle ventral midbrain (red arrows A); ganglia C). (D-F): post showing: Multiple D) E); (yellow arrow F).View Large Image Figure ViewerDownload Hi-res image Download (PPT) What is most likely which part involved as denoted by yellow Fig.3(B)?1.Tuberculoma; fascicular nuclear portion2.Toxoplasmosis; cisternal segment3.Lymphoma; segment4.Toxoplasmosis; portion Answer page: 168. The authors declare that they have no known competing financial interests or personal relationships could appeared influence work reported this paper. patient: Revisiting concentric signs – paperJournal Clinical NeuroscienceVol. 87Preview4. toxoplasmosis; Full-Text PDF