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胸椎硬膜内髓外结核瘤:对抗结核治疗的矛盾反应。

Intradural extramedullary tuberculoma of the thoracic spine: paradoxical response to antituberculous therapy.

作者信息

Takahashi Hirokatsu, Ito Shoichi, Kojima Shigeyuki, Tanno Takaaki, Hattori Takamichi

机构信息

Department of Neurology, Graduate School of Medicine, Chiba University, Chiba.

出版信息

Intern Med. 2008;47(8):797-8. doi: 10.2169/internalmedicine.47.0839. Epub 2008 Apr 16.

Abstract

Intradural extramedullary tuberculoma of the spinal cord (IETSC) is a rare complication of tuberculosis, which can occur as a paradoxical response to antituberculous therapy. A 46-year-old woman with tuberculosis meningitis developed an acute sensory disturbance and paraplegia eight weeks after the antituberculous treatment was started. MRI revealed a cystic lesion at the Th 2 and 3 vertebrae levels, and continuous dural thickening. Laminectomy was performed; soft granulomas were unexpectedly observed inside the dura matter. After the operation, the patient experienced progressive improvement in motor strength. IETSC should be known as rare but possible complication of tuberculous meningitis.

摘要

脊髓硬膜内髓外结核瘤(IETSC)是结核病的一种罕见并发症,可作为抗结核治疗的矛盾反应而出现。一名46岁患有结核性脑膜炎的女性在开始抗结核治疗八周后出现急性感觉障碍和截瘫。MRI显示胸2和胸3椎体水平有一个囊性病变,硬脑膜持续增厚。进行了椎板切除术;意外地在硬脑膜内观察到软性肉芽肿。术后,患者运动力量逐渐改善。IETSC应被视为结核性脑膜炎罕见但可能出现的并发症。

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