Intradural Extramedullary Tuberculoma of the Spinal Cord Following Tuberculous Meningitis

Jeong, Deok-Ki; Kwon, Young Min

doi:10.14245/kjs.2015.12.2.107

Cited by 10 publications

(7 citation statements)

References 19 publications

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“…[ 11 18 19 ] In patients with IETSC with neurological deficit, surgical treatment and antitubercular chemotherapy give good results with excellent prognosis. [ 10 12 19 20 ] Prompt surgical decompression will result in motor power and bladder function improvement. [ 3 15 21 ]…”

Section: Discussionmentioning

confidence: 99%

Intradural extramedullary tuberculoma masquerading en plaque meningioma

et al. 2018

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Extensive en plaque intradural extramedullary tuberculomas can occur as a paradoxical response to chemotherapy for intracranial tuberculomas. We report a case of 31-year-old male who presented with backache and progressive weakness and urgency of micturition. Magnetic resonance imaging dorsolumbar spine which showed an ill-defined T1 hypointense and T2 heterointense lesion noted posterior to the thoracic spinal cord, extending from C7 to D5 vertebral levels suggestive of en plaque meningioma. The patient underwent D1-D5 laminectomy, with subtotal debulking of the tumor. The histopathological examination of lesion was suggestive of granulomatous inflammation with multinucleated and Langhan type giant cells confirming the diagnosis of tuberculoma.

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Section: Discussionmentioning

confidence: 99%

Intradural extramedullary tuberculoma masquerading en plaque meningioma

et al. 2018

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“…The ischemic hypothesis proposes that obliterative endarteritis caused by tuberculosis can lead to softening of the damaged spinal cord parenchyma. The other hypothesis proposes that meningeal scarring can Post-operative syringomyelia in tuberculosis has been reported twice [12,13]. However, in both of these cases the cause was attributed to a pre-existing intradural-extramedullary tuberculoma with concurrent arachnoiditis.…”

Section: Discussionmentioning

confidence: 99%

Tetraplegia associated with post-operative syringomyelia in spinal tuberculosis: a result of an epidural compartment syndrome?

Bhatnagar

Kataria

Lingaiah

et al. 2019

Spinal Cord Ser Cases

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Introduction The commonly recognized causes of post-operative neurological deterioration in spinal tuberculosis are inadequate decompression, damage to vascular supply of the spinal cord, and multi-drug resistant organisms. There are no known cases of syringomyelia developing after surgical decompression of spinal tuberculosis. Case presentation A teenage girl presented with rapid onset quadriparesis secondary to a tubercular epidural abscess extending from C4-T8. The neurological status deteriorated to quadriplegia immediately following decompression by hemilaminectomy at C7 and T7 levels. Investigations into the cause of neurological deterioration revealed syrinx formation at T5-9 levels. The patient had partial motor and sensory recovery in the first 3 weeks post-operatively. Tubercular infection was treated with a 1-year course of multi-drug anti-tubercular therapy. However, there was no further neurological improvement at 2 years follow-up. Discussion Syringomyelia in tuberculosis has been associated with tubercular meningitis, intradural tuberculomas, and postsurgical vascular insult. None of these were implicated as the cause of syrinx formation in this case. We hypothesize that the rapid evolution of epidural abscess in an intact vertebral column led to an acute "epidural compartment syndrome", which caused ischemic damage to the spinal cord. Compression caused by the epidural abscess was relieved by surgical decompression, allowing the central canal to dilate and expand into the softened spinal parenchyma, hence leading to syrinx formation.

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“…Only 2%–5% of CNS tuberculomas are considered to be intradural spinal tuberculomas 3 4. Non-osseous spinal tuberculoma is relatively uncommon among these conditions 6. Intradural extramedullary tuberculosis is the most unusual kind, occurring in only 1 out of every 50 000 tuberculosis cases 7.…”

Section: Discussionmentioning

confidence: 99%

Intradural extramedullary tuberculoma of the spinal cord mimicking meningioma

et al. 2022

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Intradural extramedullary tuberculoma of the spinal cord is an extremely rare central nervous system tuberculosis manifestation. It is even rarer in patients who have no history of primary tuberculosis. A total of five cases, including the present case of intradural extramedullary tuberculoma without a history of primary tuberculosis, have been reported in the literature. We report a case of a male patient in his 20s who came with progressive weakness in his lower limbs, urinary incontinence and MRI features suggestive of meningioma. The patient underwent a D9–11 laminectomy with total debulking of the tumour. The histopathological examination revealed Langhans-type giant cells, confirming the diagnosis of a tuberculoma. The patient was advised an antitubercular therapy for 18 months. On a follow-up after 1 month, the patient could walk without support and had no urinary incontinence, indicating the importance of prompt surgical resection and adequate antitubercular therapy for a better outcome.

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Intradural Extramedullary Tuberculoma of the Spinal Cord Following Tuberculous Meningitis

Cited by 10 publications

References 19 publications

Intradural extramedullary tuberculoma masquerading en plaque meningioma

Intradural extramedullary tuberculoma masquerading en plaque meningioma

Tetraplegia associated with post-operative syringomyelia in spinal tuberculosis: a result of an epidural compartment syndrome?

Intradural extramedullary tuberculoma of the spinal cord mimicking meningioma

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