The incidence of traumatic spinal cord injury is reported as 30-40 million per year. Among these, stab wounds to the spinal canal are usually rare. These injuries often lead to complete or incomplete neurological deficits. An appropriate management can ensure good functional recovery for approximately two-third of the patient. As these cases are uncommon, their treatment protocols are still controversial and under evaluation. Some literatures reveal various surgical approaches. Spinal canal injury with retained part of the causative agent (knife, bullet, glass etc.) or any other complication on the wound site demands immediate surgical exploration. Here we report on a patient with a retained metallic foreign body (tip of knife) in the thoracic region traversing the left pedicle of sixth thoracic vertebrae along with spinal canal with paraparesis and after neuro-surgical exploration and complete removal of the foreign body, patient shows gradual improvement of neuro-functional status. Proper wound care and long term close follow up was ensured during post operative period.
Despite being potentially remediable, central nervous system tuberculosis continues to be a major cause of morbidity and mortality in developing countries. Intracranial tuberculoma is one of the many presentations of CNS tuberculosis that can occur as solitary or multiple lesions. When tuberculomas are solitary and extremely large, they may cause increased intracranial pressure, compressive focal neurological deficits, or epileptic seizures mimicking a malignant lesion. Even using magnetic resonance imaging and spectrography, giant tuberculoma and brain tumors could be mistaken for one another, which warrants consideration of an infectious etiology as a diagnostic differential for prompt diagnosis and appropriate treatment plan. This case study demonstrates a 22-year-old woman who presented with headache, nausea and vomiting ,blurring of vision , weakness of the right side of the body, and features of frontal lobe syndrome with no particular clinical features of TB, and underwent craniotomy who had a preoperative diagnosis of brain tumor. Histopathology later revealed it to be a tuberculoma. J Shaheed Suhrawardy Med Coll 2021; 13(2): 177-182
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