\documentclass[10pt]{article}

\usepackage{fullpage}
\usepackage{setspace}
\usepackage{parskip}
\usepackage{titlesec}
\usepackage[section]{placeins}
\usepackage{xcolor}
\usepackage{breakcites}
\usepackage{lineno}
\usepackage{hyphenat}





\PassOptionsToPackage{hyphens}{url}
\usepackage[colorlinks = true,
            linkcolor = blue,
            urlcolor  = blue,
            citecolor = blue,
            anchorcolor = blue]{hyperref}
\usepackage{etoolbox}
\makeatletter
\patchcmd\@combinedblfloats{\box\@outputbox}{\unvbox\@outputbox}{}{%
  \errmessage{\noexpand\@combinedblfloats could not be patched}%
}%
\makeatother


\usepackage{natbib}




\renewenvironment{abstract}
  {{\bfseries\noindent{\abstractname}\par\nobreak}\footnotesize}
  {\bigskip}

\titlespacing{\section}{0pt}{*3}{*1}
\titlespacing{\subsection}{0pt}{*2}{*0.5}
\titlespacing{\subsubsection}{0pt}{*1.5}{0pt}


\usepackage{authblk}


\usepackage{graphicx}
\usepackage[space]{grffile}
\usepackage{latexsym}
\usepackage{textcomp}
\usepackage{longtable}
\usepackage{tabulary}
\usepackage{booktabs,array,multirow}
\usepackage{amsfonts,amsmath,amssymb}
\providecommand\citet{\cite}
\providecommand\citep{\cite}
\providecommand\citealt{\cite}
% You can conditionalize code for latexml or normal latex using this.
\newif\iflatexml\latexmlfalse
\providecommand{\tightlist}{\setlength{\itemsep}{0pt}\setlength{\parskip}{0pt}}%

\AtBeginDocument{\DeclareGraphicsExtensions{.pdf,.PDF,.eps,.EPS,.png,.PNG,.tif,.TIF,.jpg,.JPG,.jpeg,.JPEG}}

\usepackage[utf8]{inputenc}
\usepackage[english]{babel}



\usepackage{float}








\begin{document}

\title{Large Cerebral Tuberculoma}



\author[1]{Nor Osman Sidow}%
\affil[1]{Somalia Mogadishu Turkey Recep Tayyip Erdogan Training and Research Hospital}%


\vspace{-1em}



  
  \date{June 13, 2024}


\begingroup
\let\center\flushleft
\let\endcenter\endflushleft
\maketitle
\endgroup








\sloppy


\textbf{Large Cerebral Tuberculoma}

\textbf{Nor Osman SIDOW, M.D.}

\textbf{Mogadishu Somalia Turkey Training and Research Hospital}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/image1/image1}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/image2/image2}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/image3/image3}

\end{center}
\end{figure}

Figure 1: This is an MRI brain that shows a lesion with vasogenic oedema
in the right fronto-pareital region (A), and after IV Gad contrast, it
shows lesion with leptomeningeal enhancement of both cerebral
hemispheres (B and C).

A previous healthy 7-year-old boy comes at the neurology out-patient
department with right side hemiparesis, altered of speech,and seizure
for six months. No previous history of Tuberculosis or other chronic
diseases. Physical examination, he was afebrile and no meningeal signs,
there was right side weakness (power 3/5). Magnetic resonance imaging of
the head with intravenous gadolinium showed ring contrast enhancement on
post-contrast images was observed. Widespread vasogenic edema was
observed around this described lesion (Figue 1: A). A shift reaching 18
mm to the right in the midline of the brain was observed. In addition,
leptomeningeal enhancement areas were detected in both cerebral
hemispheres. Findings are highly compatible with intracranial
tuberculoma and accompanying meningitis (Figure 1: B and C), and the HIV
test was negative. Resection was planned and performed. Histological
findings showed caseous necrosis with giant multinucleated cell of Acid
Fast Bacillae. The patient was started with 1 year of ant-tubercle
treatment. His symptoms improved. Tuberculoma and TB meningitis are two
of the devastating complications of TB, which require prolonged
treatment and have a poor prognosis {[}1,2,3{]}.

Author Contribution: The author has been fully contributed and approved
for the final draft.

Conflict of interest: The author has no any conflict of interest to
report.

Consent: A written informed consent was obtained for the patient's
father to publish this image report.

Funding: No funding is avalibale.

Reference

\begin{enumerate}
\tightlist
\item
  Wilkinson, R. J., Rohlwink, U., Misra, U. K., Van Crevel, R., Mai, N.
  T. H., Dooley, K. E., \ldots{} \& Thwaites, G. E. (2017). Tuberculous
  meningitis.~\emph{Nature reviews neurology} ,~\emph{13} (10), 581-598.
\item
  Marx, G. E., \& Chan, E. D. (2011). Tuberculous meningitis: diagnosis
  and treatment overview.~\emph{Tuberculosis research and treatment}
  ,~\emph{2011} .
\item
  DeLance, A. R., Safaee, M., Oh, M. C., Clark, A. J., Kaur, G., Sun, M.
  Z., \ldots{} \& Parsa, A. T. (2013). Tuberculoma of the central
  nervous system.~\emph{Journal of Clinical Neuroscience} ,~\emph{20}
  (10), 1333-1341.
\end{enumerate}

\selectlanguage{english}
\FloatBarrier
\end{document}

