When doctors describe your brain scan as a “starry sky,” it’s not good

A 57-year-old man's MRI scan revealed tuberculomas—small nodules—in his brain, indicating a rare but dangerous form of tuberculosis that has invaded his central nervous system rather than just his lungs. After previously being treated for lung TB and arriving at the emergency department with unexplained headaches, neck pain, and tingling in his right hand, doctors discovered these lesions on imaging tests. The condition, classified as CNS tuberculoma, highlights how the bacteria can spread to other parts of the body, making it a significant but underrecognized complication that could be life-threatening if untreated.