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Epilepsy CT Criteria Differentiating a Solitary Cysticercus Granuloma from Tuberculoma

Purpose: To distinguish a small cysticercus granuloma from a solitary tuberculoma in the CT head images from a patient with epilepsy.

Description

The differentiation between a small cysticercus granuloma and a tuberculoma in the computed tomographic (CT) study of the head from a patient with epilepsy is a common problem in many parts of the developing world. Rajshekar et al identified certain features that can help separate these 2 conditions. The authors are from the Christian Medical College in Vellore, India.


 

Parameters:

(1) largest diameter in mm

(2) outline

(3) midline shift

 

Parameters

Cysticercus Granuloma

Tuberculoma

diameter in mm

100% < 20 mm

100% > 20 mm

irregular outline

4%

83%

regular Type A

80%

17%

regular Type B

16%

0%

midline shift

0%

67%

from Table 2, page 403

 

where:

• Type A outline = round or oval, appearing as a ring or disc.

• Type B outline = Type A with additional smaller "daughter" lesion.

• The midline shift was associated with a greater amount of edema about the tuberculoma.

 


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Specialty

Objective

ICD-10