Niazi Farheen, Badshah Mazhar, Irshad Muhammad, Rao Sohail
Department of Neurology, Pakistan Institute of Medical Sciences, Islamabad.
J Coll Physicians Surg Pak. 2010 Feb;20(2):132-4.
Tubeculosis commonly involves the nervous system, but involvement of spinal cord in the form of intramedullary tuberculoma is rare and concurrent occurrence of cranial and intramedullary tuberculomas is extremely rare. We report a case of concurrent occurrence of intramedullary tuberculoma with multiple intracranial tuberculomas in a young girl from Islamabad, who presented with one month history of paraplegia and with a sensory level at T6. MRI spine showed a well circumscribed lesion opposite T6, which was diagnosed as intramedullary tuberculoma. On cranial imaging, she was found to have multiple round contrast enhancing lesions which were diagnosed as intracranial tuberculomas based on their typical MRI findings. She had complete recovery with conventional treatment of ATT and steroids, without any surgical intervention. The follow-up MRI of patient showed disappearance and complete resolution of most of the lesions.
结核病常累及神经系统，但以髓内结核瘤形式累及脊髓的情况罕见，而颅内和髓内结核瘤同时发生极为罕见。我们报告一例来自伊斯兰堡的年轻女孩，她同时患有髓内结核瘤和多发颅内结核瘤，患者有1个月截瘫病史，T6水平存在感觉平面。脊柱MRI显示T6水平对应处有一个边界清晰的病变，诊断为髓内结核瘤。头颅影像学检查发现她有多个圆形强化病变，根据其典型的MRI表现诊断为颅内结核瘤。经抗结核治疗（ATT）和类固醇药物的常规治疗，她完全康复，未进行任何手术干预。患者的随访MRI显示大多数病变消失并完全消退。
