COMPUTED TOMOGRAPHY (CT) SCAN

RING ENHANCING LESIONS ON BRAIN

Abstract

Ring enhancing lesions are a common neurological problem seen in either
gender and in all age groups. Objectives: To determine the clinical presentations and etiological
factors in patients with ring enhancing lesion on CT scan brain. Design: Case series study.
Period: One year. Setting: Department of medicine, Liaquat University Hospital, Hyderabad.
Patients and methods: Subjects of either sex ≥12 years of age, presented with seizures, fever,
focal neurological signs and deficit, headache, weight loss and vomiting and had single or
multiple ring enhancing lesions on computed tomography (contrast CT brain film) were enrolled
and entered in the study. CT scan brain was advised to evaluate any identified lesion and then
certain specific biochemical tests were also advised to detect the particular existence etiological
factor. The data was analyzed in SPSS 16 and the frequency and percentage was calculated.
Results: During one year study period, total 50 subjects were detected as ring enhancing lesion
on CT scan. The mean age ±SD of the over all population was 28.87±4.84 whereas the mean
age ±SD of male and female population was 27.76±6.53 and 30.76±5.83 respectively. Ring
enhancing lesions were right sided in 30 patients (60%), on the left side in 15 (30%) and bilateral
lesions were identified in 6 subjects (10%) on brain imaging. Majority of the ring enhancing
lesions were single 45 (90%) and the parietal lobe was observed as the commonest site. The
headache, seizures, fever, pyramidal signs and papilledema was identified the common clinical
features whereas the common etiological factors responsible for ring enhancing impression on
brain CT scan were tuberculoma 17(34%), brain tumor 12(24%), metastasis 05(10%) and brain
abscess 04(08%). Conclusions: The male population was predominant while the seizure was
observed as common clinical feature whereas the tuberculoma, brain tumour and metastasis
are the common etiological factors responsible for ring enhancing lesion on brain imaging.