传播性结核病由圆中枢结核瘤揭示出来
Arielle Sobngwi1, William Vindrios2, Caroline Apra3
1Neurosurgery Department, Henri Mondor Hospital, Créteil, France; Université Paris Est Créteil, Créteil, France.
World neurosurgery
|February 3, 2024
概括
一名年轻男子患有快速进展的,被诊断为脊柱结核病. 迅速的抗结核治疗导致神经系统完全恢复,避免了手术和潜在的恶化.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 放射学 放射学是指放射学
背景情况:
- 脊髓病变呈现神经缺陷需要彻底的差异诊断.
- 结核病可以在中枢神经系统中表现出来,模仿其他病理.
研究的目的:
- 报告一个脊髓结核瘤病例,呈现为状骨髓损伤.
- 突出诊断过程和成功管理神经结核病.
主要方法:
- 磁共振成像 (MRI) 和计算机断层扫描 (CT) 用于病变特征.
- 阳位子发射断层扫描 (PET) 扫描评估了代谢活动.
- 淋巴结活检的组织病理学和分子分析 (聚合酶链反应) 证实了Mycobacterium tuberculosis.
- 进行了淋巴结,尿液,脑脊液和唾液的培养.
主要成果:
- 核磁共振扫描显示了对比度增强的髓损伤和脑.
- 检测到广泛的系统性参与,包括肺结节和前列腺/精液囊病变.
- 淋巴结活检证实了颗粒状炎症,对Mycobacterium结核病DNA呈阳性.
- 用皮质类固醇治疗抗结核病导致神经系统完全恢复,并在MRI上减少脊髓胀.
结论:
- 脊髓结核瘤应考虑在状骨髓病变的差异诊断中,特别是在特有地区.
- 通过抗结核疗法进行非手术治疗可以非常有效.
- 避免在神经结核病例中进行手术,可以防止产生神经毒素的神经系统恶化.
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