case_images: PMC10559370_01
case_images: Left column (a) showing the patient's preoperative dystonic, "thalamic," hand that was contracted in this position indefinitely from November 2022. The right column (b and c) from June 2023 illustrates the complete resolution of the dystonia and a full range of movements and power of the initially hemiparetic side.
case_images: SNI-14-350-g001.jpg
case_images: PMC10559370_01_SNI-14-350-g001.jpg
case_images: F1
case_images: The patient had an ataxic gait and focal dystonia in the form of a "thalamic hand" [Figure 1a (preoperative), Figures 1b and 1c showing complete resolution at last follow-up]. At her 8th-month follow-up, her dystonic hand has resolved to complete normality, and she has regained a complete range of motion in her right limbs [Figures 1b and c].
case_images: Top row T1 contrast; (bottom left) Fluid attenuated inversion recovery (FLAIR) sequence; (bottom right) T2 sequence. From radiology report - An ill-defined intra-axial heterogeneous lobulated lesion with crenated margins demonstrating patchy contrast enhancement, returning T2 and FLAIR signals involving the right thalamus, posterior limb of the internal capsule, the right half of the midbrain, ipsilateral temporal lobe, hippocampal region, and abutting the splenium of the corpus callosum. There is marked perilesional vasogenic edema. The lesion exerts a mass effect on the body and trigone of the ipsilateral and third ventricles.
case_images: SNI-14-350-g002.jpg
case_images: PMC10559370_01_SNI-14-350-g002.jpg
case_images: F2
case_images: The following day, a magnetic resonance imaging (MRI) brain, revealed an ill-defined intra-axial heterogeneous lobulated lesion with crenated margins involving the right thalamus, the posterior limb of the internal capsule ipsilaterally, and several other neural structures that were being compressed from vasogenic edema causing mass-effect [Figure 2]. Figure 2 shows her baseline MRI and its associated findings.
case_images: (Left) T1 contrast; (Middle) Fluid attenuated inversion recovery (FLAIR) sequence; (Right) T2 sequence. 8-month follow-up magnetic resonance imaging showing a near complete resolution of the lesion.
case_images: SNI-14-350-g003.jpg
case_images: PMC10559370_01_SNI-14-350-g003.jpg
case_images: F3
case_images: Follow-up MRI [Figure 3] shows a significant reduction in her tuberculoma size.