Tuberculous meningitis remains an important disease, becoming more common as an infectious agent in AIDS patients. As a rule, the evolution is less rapid than in pyogenic infections. Vasculitis and cerebral infarction, caused by inflammatory changes in the basal cisterns, are more prevalent. The MR features of tuberculous meningitis are similar to the bacterial agents, but the chronic inflammation induces thick granulation tissue that produces a more striking enhancement pattern. Actual intracranial tuberculomas are rare in the United States. Mature tuberculomas are T2 hypointense. Central necrosis in some lesions results in a T2 bright core with a low signal intensity rim.

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