Ring Enhancing Lesions on Brain Imaging

Twenty-five patients of intracranial small ring (multiple / single) enhancing lesions were studied, 10 males and 15 females, age group of 20 to 40 years. Common presentation was seizures (68%), headache (68%), fever and focal neurological deficit. The various lesions were tuberculoma (48%), neurocysticercosis(32%), malignancy (12%), brain abscess and toxoplasmosis (4%). On MRI, single ring enhancing lesions were seen in 76%, multiple in only 24%. The size of the solitary lesions ranged from 0-10 mm. Commonest site was frontal lobe encountered in 36%; 12% lesions were encountered in parietal lobe. Other sites were lentiform nucleus, cerebellum, globus pallidus, pons. One patient had multiple lesions scattered in bilateral cerebral hemispheres. Patients were treated with anticonvulsants, anti helminthic/ antitubercular drugs, etc as per the aetiology. Neurocysticercosis showed 75% complete resolution after a 3 weeks course of Albendazole with steroids. Symptoms and MRI scan findings can resolve with prompt treatment.