Frontal Tuberculoma Presenting With Atypical Foster Kennedy Syndrome in a Pregnant Patient

Foster Kennedy syndrome (FKS), accounting for 1%-2.5% of intracranial masses, typically arises in the frontal lobe and may result from various etiologies, including rare causes such as tuberculoma. Although the incidence of central nervous system (CNS) tuberculosis is increasing, published reports in this setting remain scarce. We report the case of a 32-year-old pregnant woman with a history of childhood asthma who presented with progressive headaches and neurological symptoms. Initially treated for eclampsia, she was later referred for neurological assessment. Clinical evaluation and neuroimaging revealed a supratentorial, intra-axial lesion in the left frontal lobe. Surgical resection and histopathology confirmed a cortico-subcortical lesion, prompting further investigations, including GeneXpert testing, lumbar puncture (LP), and chest imaging. Antituberculous therapy was initiated upon confirmation of tuberculoma and identification of a probable pulmonary focus. This case illustrates an atypical form of FKS secondary to frontal tuberculoma with cerebrospinal fluid (CSF) disruption in the absence of meningitis-an exceptionally rare presentation. It highlights the importance of considering tuberculoma in the differential diagnosis of intracranial masses, particularly in endemic regions.