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Multiple tuberculomas in the brain and spinal cord: a case report
Han-Lin Yen1, Reng-Jye Lee, Jui-Wei Lin
1Department of Neurosurgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan. yhl7612@ms1.hinet.net
Spine
|December 4, 2003
Summary
Disseminated tuberculomas in the central nervous system (CNS) are rare. This case highlights the effectiveness of antituberculous therapy and surgical decompression for managing spinal cord and brain tuberculomas.
Area of Science:
- Neurology
- Infectious Diseases
- Pathology
Background:
- Intramedullary tuberculoma with disseminated intracranial tuberculoma is exceptionally rare, with only one prior reported case.
- This report details the second documented instance of this unusual presentation.
Observation:
- A 67-year-old male with miliary tuberculosis presented with acute paraparesis due to spinal cord tuberculomas.
- Magnetic resonance imaging (MRI) revealed additional tuberculomas in the brainstem, cerebellum, and cerebral hemispheres.
Findings:
- Combined medical and surgical management led to gradual improvement in muscle power over six months.
- Antituberculous medication proved effective in treating multiple central nervous system tuberculomas.
Implications:
- This case underscores the efficacy of antituberculous treatment for CNS tuberculomas.
- Surgical intervention is crucial for cord or brain decompression in cases of progressive neurological deficits and for pathological examination.