Abstract
Tuberculosis (TB) affecting the central nervous system (CNS) is rare, often mimicking other intracranial pathologies such as meningiomas, especially when located in the anterior skull base. Despite a global reduction in TB incidence, CNS TB continues to present diagnostic challenges due to its nonspecific imaging characteristics. We report a case of a 39-year-old male with symptoms including persistent headache, vertigo, and visual disturbances. Initial imaging suggested meningioma; however, histopathology revealed a tuberculoma. The patient responded well to antitubercular therapy following surgery. This case emphasizes the necessity of considering TB in differential diagnoses of intracranial lesions, especially in endemic regions, to prevent misdiagnosis and ensure timely treatment. CNS TB, though rare, should be a differential consideration in intracranial lesions to avoid delays in diagnosis and improve clinical outcomes.