Multiple tuberculomas in the brain and spinal cord: a case report.

Abstract

A case of disseminated tuberculoma in the spinal cord and brain is reported. To present a case of disseminated tuberculoma in the spinal cord and brain and to describe the unusual pathologic features and clinical presentation. DATA Intramedullary tuberculoma concomitant with intracerebral disseminated tuberculoma is rare. Only one other case has been reported in the world literature. This represents the second reported case of this unusual lesion. The authors report a 67-year-old man with miliary tuberculosis of the lung and started on antituberculous therapy. His pulmonary complaints were resolved, but he presented acute paraparesis caused by tuberculomas in the thoracolumbar spinal cord. MRI showed more tuberculomas in the brain stem, cerebellum, and cerebral hemispheres. After 6 months, the patient's muscle power gradually improved with a combination of medical and surgical management. Our experience indicates that antituberculous medication is effective in managing multiple central nervous system tuberculomas. The purpose of surgical intervention is to decompress the cord or brain when progressing neurologic defects occur and to examine the tissue pathologically.