Which brain imaging finding is most characteristic of tuberous sclerosis?

• A. Subependymal nodules
• B. Meningioma
• C. Glioblastoma
• D. Pinealoma

Answer: (A)

In tuberous sclerosis, the brain shows hamartomatous lesions including subependymal nodules that line the walls of the lateral ventricles. These nodules often calcify, so imaging—especially CT—reveals small, calcified intraventricular nodules along the ventricles. This calcified subependymal pattern is a hallmark of the condition and helps distinguish it from other brain tumors such as meningioma, glioblastoma, or pinealoma, which do not present as calcified subependymal nodules in this clinical context. Subependymal nodules can sometimes grow into a subependymal giant cell astrocytoma near the foramen of Monro, potentially causing hydrocephalus.