Multiple Brain Tuberculomas in a 32-year-old Woman with Chronic Headache

Tuberculosis (TB) has re-emerged in the two past decades as a major health problem worldwide. Presently, more than 2 billion people (one third of the world population) are infected with TB, of which approximately 10% will develop the clinical disease. The incidence of central nervous system (CNS) TB is related to the prevalence of TB in the community, and it is still the most common type of chronic CNS infection in developing countries. We describe a 32-year-old woman, who presented with chronic headache, followed by gaze palsy and decreased level of consciousness. The disease was diagnosed through TB PCR of the cerebrospinal fluid (CSF). Anti TB drugs and corticosteroid were started for her and she responded successfully to treatment. We conclude that TB of CNS should be considered in patients with chronic headache, particularly in endemic regions because its diagnosis may be missed.