Highlights
Recurrent tubercular brain abscess is a rare pathology in immunocompetent children.
Recurrence is possible despite a well-managed treatment such as surgery and anti-tuberculosis therapy.
Early management and careful monitoring are important.
The addition of corticosteroid therapy and readjustment of the dose of anti-tuberculosis drugs are necessary to achieve a cure.
Our treatment was based on several punctures of the abscess associated with a shunt, a readjustment of doses of antituberculosis drugs and additional corticosteroid therapy which led to a clinical improvement.
This clinical case of intramedullary arachnoid cyst is the second reported case in Senegal. It concerns a 50-yearold woman, with no particular history, admitted for back pain associated with intermittent spinal claudication. The physical examination showed a dorsal spinal syndrome, spastic paraparesis, hypoesthesis under T9 sensitive territory with bilateral Babinski sign. Cutaneous-abdominal reflexes were abolished at T8. Magnetic resonance imaging (MRI) revealed an intramedullary cyst formation. The patient was operated on the day after her admission by a posterior approach with scopic tracking. She underwent a laminectomy from T7 to T9. Thereafter the cyst has been removed, then discharged three days after the surgery. The clinical follow-up showed a full recovery.
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