Syringomyelia developing as an acute complication of tuberculous meningitis
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A K Daif1, S al Rajeh, A Ogunniyi
1Division of Neurology and Radiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Background:
Tuberculosis of the nervous system has protean manifestations. Syringomyelia, though an uncommon complication of it, is usually of late onset.
Methods:
We report two patients with tuberculosis meningitis who developed syringomyelia acutely. The diagnosis was supported by neuroimaging and findings at laminectomy.
Results:
The two patients developed syringomyelia between 11 days and 6 weeks of the onset of tuberculous meningitis. They both had cord swelling and softening.
Conclusions:
Acute-onset syringomyelia should be suspected in any patient being treated for tuberculosis meningitis who subsequently develops limb weakness and/or sphincteric dysfunction. Inflammatory edema and cord ischemia appeared to be the underlying mechanisms in these early onset cases rather than arachnoiditis which is important in late-onset cases.