Concurrent intracranial tuberculomas and spinal tuberculosis with multifocal abscesses: a rare case report

Neurotuberculosis is a severe form of tuberculosis affecting the central nervous system, manifesting as tuberculomas or abscesses. Simultaneous intracranial and spinal tuberculomas with abscesses are exceptionally rare, presenting unique diagnostic and therapeutic challenges.

A 40-year-old female presented with headaches, seizures, and lower limb weakness. The magnetic resonance imaging (MRI) revealed multiple intracranial and spinal tuberculomas with abscesses. She was treated with antitubercular therapy and corticosteroids, along with surgical drainage, leading to significant improvement.

Neurotuberculosis can present without evident pulmonary involvement, making early diagnosis crucial. MRI plays a key role in identifying tuberculomas, which must be differentiated from other lesions such as neurocysticercosis or gliomas. Conservative management with ATT and steroids is often effective, particularly in resource-limited settings. Surgical intervention is reserved for cases with severe neurological deficits or diagnostic uncertainty.

This case highlights the need to consider neurotuberculosis in patients with neurological symptoms, especially in endemic areas. The rarity of concurrent intracranial and spinal tuberculomas with abscesses requires a multidisciplinary approach for early diagnosis and effective management.