Non‐osseous intradural tuberculoma of the thoracic spine with compressive myelopathy

Autor: Shyam Duvuru, Vivek Sanker, Syed Naureen, Gupta Prakash, Rajurkar Sanjana, Tirth Dave
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Clinical Case Reports, Vol 11, Iss 11, Pp n/a-n/a (2023)
Druh dokumentu: article
ISSN: 2050-0904
DOI: 10.1002/ccr3.8131
Popis: Key Clinical Message An uncommon form of CNS tuberculosis called non‐osseous IDEM tuberculoma frequently results from paradoxical drug interactions. It should be considered one of the differentials when patients receiving ATT experience acute neurological impairment. Abstract Tuberculoma affecting the spinal cord is a rare condition in modern times. The occurrence of non‐osseous intradural tuberculosis, specifically in the spine, is even more exceptional. In fact, it is uncommon to encounter an intradural extramedullary tuberculous granuloma that lacks radiological indications of vertebral involvement, especially within the thoracic region. We present a case of a patient with a neurological deficit caused by a non‐osseous intradural tuberculoma in the thoracic region, without any associated bone involvement. The patient experienced a gradual deterioration of neurological function. An MRI of the thoracic spine revealed the presence of a tuberculoma located intradurally, extramedullary, and juxtamedullary of the T5 vertebra. The compression of the spinal cord resulted in paraparesis which was worsening to paraplegia. A D4–D6 laminectomy and microsurgical excision were performed under intraoperative neurophysiological monitoring (IONM), and the patient showed clinical recovery. Excellent clinical outcomes were achieved. However, it is crucial to consider the possibility of a non‐osseous intradural tuberculoma as a rare condition when encountering a SOL, particularly in patients with a history of tuberculosis and spinal cord compression. In cases where a progressing neurological deficit is present, a combination of surgical intervention and anti‐tuberculous treatment should be considered as the optimal approach.
Databáze: Directory of Open Access Journals
Nepřihlášeným uživatelům se plný text nezobrazuje