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Case Reports
. 2013 Jul;54(1):61-4.
doi: 10.3340/jkns.2013.54.1.61. Epub 2013 Jul 31.

Disseminated tuberculosis of central nervous system : spinal intramedullary and intracranial tuberculomas

Yu Seok Lim  1 , Sung Bum Kim, Min Ki Kim, Young Jin Lim
Affiliations
Case Reports

Disseminated tuberculosis of central nervous system : spinal intramedullary and intracranial tuberculomas

Yu Seok Lim et al. J Korean Neurosurg Soc. 2013 Jul.

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.

Keywords: Antituberculous treatment; Intramedullary lesion; Tuberculoma.

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Figures

Fig. 1
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.
Fig. 2
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.
Fig. 3
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).
Fig. 4
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.
Fig. 5
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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