This case reports a young woman presenting with headache and blurred vision, with imaging revealing multiple ring-enhancing micronodules diffusely distributed throughout the brain, exhibiting a starry sky pattern. The patient had a history of medication abortion 3 weeks prior. Laboratory tests showed significantly elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), strongly positive serum T-cell spot test (T-SPOT), and chest CT demonstrating miliary nodules in both lungs. Integrated with the laboratory findings and imaging features, the patient was ultimately diagnosed with miliary cerebral tuberculosis complicated by pulmonary tuberculosis. Symptoms markedly improved after antitubercular therapy. This article reviews and discusses the differential diagnostic approach to intracranial multiple ring-enhancing lesions (starry sky sign).