Intramedullary tuberculoma: A case report

Abstract

Study design We report a case of intra-medullary tuberculoma in a 22 year-old man with progressive paraparesis and sphincter dysfunction. Objectives To present a case of intra-medullary tuberculosis and to describe the MRI's contribution to the diagnosis. Summary of background data Intra-medullary spinal tuberculoma is a rare form of central nervous system tuberculosis. The subject and diagnosis methods The patient, a 22 year-old man, presented with an intra-medullary tuberculoma of the dorsal spinal cord diagnosed after 6 month history of progressive paraparesis and sphincter dysfunction. MRI visualized ring enhancement of the intra-medullary dorsal lesion. Results Total resection of the intra-medullary mass was performed through a posterior myelotomy. Histological examination revealed a granulomatous necrosis with caseum. The patient was treated with four anti-tuberculosis drugs in association with corticotherapy. The paraparesis and sphincter dysfunction improved. Conclusions Intra-medullary spinal tuberculoma is rare, but must be considered in the differential diagnosis of spinal cord compression.