Intramedullary spinal tuberculoma - A case report

Study Design. A case report showing an intramedullary thoracic spinal tuber culoma secondary to pulmonary tuberculosis in a 16-year-old patient with fi ndings of sub-acute cord compression. Objectives. The significance and the use of magnetic resonance imaging in t he diagnosis of intramedullary tuberculoma, and the treatment of the patien t that involves surgically the excision of intramedullary lesion followed b y appropriate antituberculous therapy. Summary of Background Data. Tuberculomas of spinal cord are rare entities. The possibility of intramedullary tuberculoma should be seriously considere d when an intraspinal mass is found, provided that pulmonary tuberculosis i s present in the history of the patient. Method. Th4-Th5 laminectomy was performed, intramedullary tuberculoma was e xcised through a myelotomy. Antituberculous treatment was applied after the surgery. Results. Excellent clinical outcome was obtained with a combination of both medical and surgical treatments. Conclusion. The intramedullary spinal tuberculoma, although a rare entity, must be considered in the differential diagnosis of the spinal cord compres sion in patients with a history of tuberculoma, human immunodeficiency viru s, and those who have a bad socioeconomic condition and bad nutrition habit . When confronted with surgical resection and antituberculous chemotherapy with the avoidance of steroids should be the choice of treatment for intram edullary tuberculomas, magnetic resonance imaging.