Intracranial tuberculoma with adjacent inflammatory aneurysms.

We describe for the first time a case of intracranial tuberculoma with adjacent intracerebral inflammatory aneurysms, and include a brief discussion of the developmental mechanism of these pathologies. A 28-year-old woman presented with a history of intermittent seizure attacks. She had been diagnosed as having pulmonary tuberculosis 1 year previously, and had been treated with antituberculosis medications for 9 months. Her brain MRI revealed a 1-cm-diameter round subcortical mass lesion on the left parietal lobe, which showed gadolinium enhancement. At surgery, we were surprised to find multiple small aneurysms in the distal middle cerebral arteries surrounding the mass. The mass was totally removed, and the aneurysms were secured by wrapping and fibrin tissue adhesive. The mass was diagnosed as a tuberculoma, and the aneurysms were suspected of being inflammatory in nature and associated with the patient's tuberculosis.