Skoglund Thomas S, Nilsson Daniel
Department of Neurosurgery, Sahlgrenska University Hospital, Blå Stråket 7, S-413 45 Göteborg, Sweden.
Clin Neurol Neurosurg. 2007 Feb;109(2):192-4. doi: 10.1016/j.clineuro.2006.08.002. Epub 2006 Sep 7.
This case report concerns a 21-year-old man developing left leg paresis. Evaluation with magnetic resonance imaging (MRI) showed an intramedullary tumor in the conus region. He was planned for surgery but preoperative investigation indicated he had tuberculosis and the tumor was presumed to be a tuberculoma. Antituberculous therapy was started and the patient improved neurologically. The patient was followed clinically and with consecutive MRI during 2 years and the last MRI showed that the lesion had disappeared completely. Intramedullary tuberculomas are rare but important differential diagnosis in patients with spinal cord mass lesions. The role of medical and surgical treatment of intramedullary tuberculomas is discussed.
本病例报告涉及一名21岁出现左腿轻瘫的男性。磁共振成像(MRI)评估显示圆锥区域有髓内肿瘤。他计划接受手术,但术前检查表明他患有结核病,肿瘤被推测为结核瘤。开始进行抗结核治疗,患者神经功能有所改善。在两年期间对患者进行了临床随访和连续的MRI检查,最后一次MRI显示病变已完全消失。髓内结核瘤罕见,但在脊髓肿块病变患者中是重要的鉴别诊断。本文讨论了髓内结核瘤的内科及外科治疗作用。