Magnetic resonance spectroscopy in pituitary tuberculoma

Saini KS, Patel AL, Shaikh WA, Magar LN, Pungaonkar SA
Correspondence: Dr Kamal S Saini, kamalsaini@gmail.com

ABSTRACT
Magnetic resonance spectroscopy (MRS) is a new, noninvasive method of diagnosing a lesion in cases where magnetic resonance (MR) imaging cannot reliably differentiate between two or more possible aetiologies. This case report describes a 20-year-old pregnant woman who developed sudden onset of left-sided hemiparesis. MR imaging of the brain revealed an infarct of the right middle cerebral artery and a suprasellar mass. The endocrine workup was normal. As she was 20 weeks pregnant, the option of a transsphenoidal biopsy of the pituitary lesion was rejected in favour of MRS . It demonstrated features characteristic of a tuberculoma. She showed marked clinical improvement after she was started on anti-tuberculous drugs. MRS is a rapidly-developing diagnostic modality, and may be a useful and safe option for investigating intracranial lesions in patients who cannot undergo invasive procedures.

Keywords: intracranial tuberculoma, magnetic resonance spectroscopy, pituitary diseases, tuberculosis
Singapore Med J 2007; 48(8): 783–786