Restricted diffusion is noted in a large number of non-stroke conditions including tuberculoma. According to various studies vesicular and degenerating stages of cysticercus cysts from the core showed ADC values significantly higher than tuberculomas and tuberculous abscess.
This is a patient, 25 year old female with headache and no other constitutional symptoms which on CEMR show ring enhancing lesion and T2 hyperintense core. When reported outside, it was reported as degenerating neurocyticercosis on basis of these findings as there was perilesional edema. However, these is evidence of diffusion restriction on DWI and that led us to give possibility of tubercular abscess.
Further reading-
Role of diffusion weighted imaging in differentiation of intracranial tuberculoma and tuberculous abscess from cysticercus granulomas-a report of more than 100 lesions. European Journal of Radiology - September 2005 (Vol. 55, Issue 3, Pages 384-392, DOI: 10.1016/j.ejrad.2005.02.003)
