Focal tuberculous cerebritis.

Five cases of focal tuberculous cerebritis, seen over a period of 10 years, revealed unique clinicoradiologic patterns that differentiate these lesions from other forms of cerebral tuberculosis. Histologically, the process consists of microgranulomata, a lymphocytic infiltrate, Langhans' giant cells, epithelioid cells, and variable evidence of rare tubercle bacilli. The relatively poor clinical outcome in this series indicates the importance of timely recognition of this disease so that proper treatment can be instituted as early as possible in an effort to arrest the underlying inflammatory reaction with a resulting minimum neurologic insult. Intense focal gyral enhancement on CT and a corresponding palisading gyral blush on angiography are invariably observed radiologically.