Introduction
Prevalence of tuberculosis in developing countries is significantly higher than developed nations. However, after global AIDS pandemic, cases of tuberculosis are also raised in developed countries due to marked increased in number of immunocompromised individual. In general, patients having tuberculosis is present with low grade fever, prolonged cough, occasional chest pain, fatigue and significant weight loss. Extra-pulmonary spread of tuberculosis like tuberculosis of central nervous system (CNS), especially tuberculous meningitis, is one of the leading causes of mortality in developing countries like India. The problem is further aggravated by the increasing prevalence of HIV infection. [1,2] Tubercular brain abscess (TBA) is a very uncommon manifestation of CNS tuberculosis. Prevalence of TBA is approximately 4-8% in immunocompetent individual however, in individuals with HIV-TB co-infection occurrence of TBA is raised up to 20%. [3] TBA may be unilocular or multilocular and resembles a pyogenic abscess clinically and radiological, differentiation between this two is challenging. [4] Patients may present with features of raised intracranial pressure and focal neurological deficit, depending on the site of the abscess. [5] CT-scan or MRI of the brain as well as confirming primary tuberculosis infection is helpful for diagnosing TBA. On the basis of involvement of brain parenchyma, usually combined medical and surgery is considered for management of TBA.