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Intradural extramedullary tuberculoma in a case of disseminated tuberculosis: A case report
Chitranshu Shrivastava1, Tushar Narayan Rathod1, Rushikesh Bhanudas Shahade1
1Department of Orthopedics, KEM Hospital and Seth GS Medical College, Mumbai, Maharashtra, India.
Background:
Intradural extramedullary tuberculoma of the spinal cord (IETSC) is an exceedingly rare manifestation of tuberculosis (TB) affecting the central nervous system.
Case Description:
A 33-year-old immunocompetent female with disseminated TB, including pulmonary involvement and leptomeningeal tuberculomas, developed progressive paraplegia and urinary incontinence over 2 months. Magnetic resonance imaging revealed diffuse intradural extramedullary soft tissue from C7 to L2 vertebral levels, indicative of abscess formation and severe spinal cord compression. The surgical intervention involved posterior decompression and abscess removal from D7 to L2 vertebral levels, resulting in partial resolution of granulomatous lesions.
Conclusion:
This case emphasizes the importance of considering IETSC in the differential diagnosis of spinal cord compression in TB-endemic regions. Further research is warranted to elucidate optimal management strategies, including the role of surgical intervention, in improving long-term neurological outcomes for patients with this rare but debilitating form of spinal TB.
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