Primary tuberculomas of the thoracal spinal cord: Case report

Abstract

The authors present an unusual case of intramedullary tuberculoma in a HIV-negative patient from the southeast part of Romania who demonstrated no other signs of tuberculous infection. Clinical exam: extreme spastic paraparesis in triple flexion, dorsal pain and bladder and bowel incontinence. Gd enhanced MRI revealed ring enhancing lesion with central hypointensity, suggesting granulomatous pathology. Surgical excision of the intramedullary lesions was carried out followed by anti-tuberculous chemotherapy and Baclofen tablets . !0 days postoperative MRI showed total resolution of the lesion. Two years follow up showed progressive resolution of spasticity. Following surgical excision, the patient improved significantly sensitive and modest the motility and spasticity. The management of this rare lesion is discussed and the literature reviewed.