Neuroimaging: tuberculous meningitis: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Neuroimaging: tuberculous meningitis

Sample item

A child with subacute fever and cranial nerve palsies has contrast CT showing intense enhancement of the basal cisterns with communicating hydrocephalus and basal ganglia infarcts. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Tuberculous meningitis

TB meningitis has a thick basal exudate that enhances avidly, hydrocephalus and infarcts of the basal ganglia from vasculitis of perforating arteries. Tuberculomas may coexist. Management includes antituberculous therapy with steroids and possible shunting.

Option by option

  • A. Cerebral venous thrombosis

    Venous thrombosis shows a dense sinus and venous infarcts.

  • B. Bacterial pyogenic meningitis

    Pyogenic meningitis is acute, and enhancement is typically over the convexity.

  • C. Subarachnoid haemorrhage

    SAH is hyperdense without contrast.

  • D. Tuberculous meningitis (correct)

    Correct. Basal enhancement with hydrocephalus and infarcts indicates TBM.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Tuberculous meningitis. TB meningitis has a thick basal exudate that enhances avidly, hydrocephalus and infarcts of the basal ganglia from vasculitis of perforating arteries.

Why is "Cerebral venous thrombosis" not the answer?

Venous thrombosis shows a dense sinus and venous infarcts.

Why is "Bacterial pyogenic meningitis" not the answer?

Pyogenic meningitis is acute, and enhancement is typically over the convexity.

Why is "Subarachnoid haemorrhage" not the answer?

SAH is hyperdense without contrast.

What concept does this question test?

It tests Neuroimaging: tuberculous meningitis in Radiology. Tuberculomas may coexist. Management includes antituberculous therapy with steroids and possible shunting.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuroimaging: tuberculous meningitis?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.