Multiple ring-enhancing lesions in the brain often raise many questions about the true diagnosis. The aetiologies are many neoplastic, infectious, vascular, inflammatory and demyelinating conditions and also depend on the geographical location of the patient. The two important causes of multiple ring-enhancing lesions in the cranium are multiple neurocysticercosis and multiple tuberculomas in developing countries like India. This case report illustrates how multiple ring-enhancing lesions cause a diagnostic dilemma between neurocysticercosis and tuberculoma. A young girl with a typical presentation of neurocysticercosis finally turned out to be a case of tuberculoma. A high index of suspicion is required in appropriate clinical settings to have best clinical outcome.
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