The advent of new and acute headaches poses a diagnostic challenge. The differential diagnosis comprises numerous diseases and syndromes, the prevalence of which varies depending on the geographical region. Due to increased magnitudes in international migration, the usual differential diagnostic spectrum has to be enlarged in individual cases. The presented case illustrates this dilemma and shows that, for example, tuberculosis deserves to be taken into consideration.
SteinerTJ. Evaluation and management of headache in primary care. Expert Rev Neurother2004; 4: 425–437.
2.
Rock RB, Olin M, Baker CA, et al. Central nervous system tuberculosis; pathogenesis and clinical aspects. Clin Microbiol Rev 2008; 21: 243–261.
3.
RichARMcCordockHA. Pathogenesis of tubercular meningitis. Bull John Hopkins Hosp1933; 52: 5–13.
4.
DasturDKManghaniDKUdaniPM. Pathology and pathogenetic mechanisms in neurotuberculosis. Radiol Clin North Am1995; 33: 733–752.
5.
PalurRRajshekharVChandyMJ. Shunt surgery for hydrocephalus in tuberculous meningitis: A long-term follow-up study. J Neurosurg1991; 74: 64–69.
6.
JaimovichSGTheaVCGuevaraM. Cavernous sinus tuberculoma mimicking a neoplasm: Case report, literature review, and diagnostic and treatment suggestions for tuberculomas in rare locations. Surg Neurol Int2013; 4: 158.
7.
IdrisMNSokrabTEArbabMA. Tuberculoma of the brain: A series of 16 cases treated with anti-tuberculosis drugs. Int J Tuberc Lung Dis2007; 11: 91–95.
8.
ChatterjeeSSainiJKesavadasC. Differentiation of tubercular infection and metastasis presenting as ring enhancing lesion by diffusion and perfusion magnetic resonance imaging. J Neuroradiol2010; 37: 167–171.
9.
MeyerHJFiedlerEKornhuberM. Comparison of diffusion-weighted imaging findings in brain metastases of different origin. Clin Imaging2015; 39: 965–969.
10.
SvolosPKousiEKapsalakiE. The role of diffusion and perfusion weighted imaging in the differential diagnosis of cerebral tumors. A review and future perspectives. Cancer Imaging2014; 14: 20.
11.
PengJOuyangYFangWD. Differentiation of intracranial tuberculomas and high grade gliomas using proton MR spectroscopy and diffusion MR imaging. Eur J Radiol2012; 81: 4057–4063.
12.
MoralesHAlfaroDMartinotC. MR spectroscopy of intracranial tuberculomas: A singlet peak at 3.8 ppm as potential marker to differentiate them from malignant tumors. Neuroradiol J2015; 28: 294–302.
13.
PretellEJMartinotCJrGarciaHH. Differential diagnosis between cerebral tuberculosis and neurocysticercosis by magnetic resonance spectroscopy. J Comput Assist Tomogr2005; 29: 112–114.
14.
ThwaitesGETranTH. Tuberculous meningitis: many questions, too few answers. Lancet Neurol2005; 4: 160–170.