Intramedullary cervical tuberculoma: a case report with note on surgical management

This study aims to report a relatively rare entity-intramedullary tuberculum of cervical spine-and describe its management and some key learning points. Intramedullary tuberculomas are rare entities. Intramedullary tuberculoma is most commonly found in the thoracic cord of a patient and is rarely seen in the cervical cord. We present an intramedullary cervical tuberculoma in a 21-year-old patient with finding of spinal cord compression. All 4 limbs were spastic, with grade 1 power on the right side and grade 3 power on the left side. Sensory deficit was found below the C6 level. Magnetic resonance imaging showed an intramedullary lesion at the C5 to C6 levels. Intramedullary tuberculoma was diagnosed based on clinical symptoms, physical examination, previous history, and magnetic resonance imaging. A C5 to C7 laminectomy was performed. Intramedullary tuberculoma was resected by microsurgery. One year after the surgery, strength returned to normal grade 5. Excellent clinical outcome was obtained with a combination of both medical and surgical treatments. Intramedullary cervical tuberculoma should be removed without delay to eliminate any mass effect on the neurons as soon as possible.