Isolated bilateral ptosis as the presentation of midbrain tuberculoma.

212 Figure 4b: T1W coronal post-gadolinium image just posterior to Meckel’s cave shows thickened right trigeminal nerve (black arrow) and enhancing extradural mass in middle cranial fossa (white arrow) Figure 4a: Contrast enhanced T1W coronal image shows enhancing intracranial extradural mass (black arrow) in the right middle cranial fossa with widened right foramen ovale (white arrow head) Figure 3: T2W axial image shows hypointense mass (black arrow) in the right middle cranial fossa with white matter edema in the right temporal lobe. High signal is seen within right middle ear cavity and mastoid air cells suggesting acute otitis media and mastoiditis (arrow head) course of the disease. Intracranial extension may occur through perineural spread and hence it should be clinically suspected in patients with nasopharyngeal granulocytic sarcoma who develop cranial nerve palsy.