J Korean Neurosurg Soc.  2013 Jul;54(1):61-64. 10.3340/jkns.2013.54.1.61.

Disseminated Tuberculosis of Central Nervous System : Spinal Intramedullary and Intracranial Tuberculomas

• Lim YS
• Kim SB
• Kim MK
• Lim YJ

• KMID: 2190862
• DOI: http://doi.org/10.3340/jkns.2013.54.1.61

Abstract

As a cause of spinal cord compression, intramedullary spinal tuberculoma with central nervous system (CNS) involvement is rare. Aurthors report a 66-year-old female presented with multiple CNS tuberculomas including spinal intramedullary tuberculoma manifesting paraparesis and urinary dysfunction. We review the clinical menifestation and experiences of previous reported literature.

Keyword

Tuberculoma; Intramedullary lesion; Antituberculous treatment

MeSH Terms

Aged
Central Nervous System
Female
Humans
Paraparesis
Spinal Cord Compression
Tuberculoma
Tuberculoma, Intracranial
Tuberculosis

Figure

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  Fig. 1 A : Chest X-ray showed features of bilateral pulmonary tuberculosis with multiple areas of patchy consolidation. B : Abdominal CT showed the perirenal abscess at right kidney.

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  Fig. 2 MRI of the brain showed multiple abscesses at the cerebrum. Conglomerated-ring enhancement on the post-contrast study was noted, and mild perilesional edema was seen.

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  Fig. 3 Thoracolumbar MRI showed an intramedullary, enhanced lesion with central necrosis (A : T1 enhance axial) on the conus medullaris, about 1.2×1×4 cm in size at the level of T12-L1 levels (B : T1 enhance sagittal).

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  Fig. 4 Brain MRI showed marked improvement of multiple nodular enhanced lesions at both frontoparietal lobes, the right thalamus, and both cerebellar hemispheres after 6 months of medication.

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  Fig. 5 After 6 months, spinal MRI showed that the lesions had decreased in size, including the intramedullary nodule with perilesional edema of the conus medullaris at T12-L1 (A : T2 sagittal, B : T1 sagittal enhance) and the tuberculous abscess had resolved. (C : T1 axial enhance).

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