Department of Neurology, SMS Medical College, Jaipur, Rajasthan, India.
Department of Neurology, SMS Medical College, Jaipur, Rajasthan, India.
J Infect Public Health. 2014 Jul-Aug;7(4):365-8. doi: 10.1016/j.jiph.2014.04.006. Epub 2014 Jun 13.
Central nervous system involvement is observed in no more than 10% of patients with systemic tuberculosis. Although CNS tuberculosis is not rare in endemic countries, such as India, intramedullary tuberculosis is not commonly reported. In this study, we report a case of a 40-year-old female who presented with a six-year history of insidious onset, gradually progressive, asymmetric quadriparesis. She was diagnosed with intramedullary tuberculoma at the craniovertebral junction and showed significant clinico-radiological improvement with medical management alone. To the best of our knowledge, this report describes the first case of intramedullary tuberculoma at the craniovertebral junction to be reported. With the increased availability of MRI in developing countries, it is now possible for clinicians to diagnose this condition without performing a biopsy. It is important for the clinicians in developed countries to be highly suspicious of intramedullary tuberculoma, as there has been a resurgence of CNS tuberculosis due to the emergence of the HIV pandemic.
中枢神经系统受累在系统性结核病患者中不超过 10%。虽然中枢神经系统结核病在印度等流行国家并不罕见，但脊髓内结核并不常见。在本研究中，我们报告了一例 40 岁女性患者，其病史为隐匿起病、逐渐进展、非对称性四肢瘫痪六年。她被诊断为颅颈交界区脊髓内结核瘤，仅通过药物治疗就取得了显著的临床和影像学改善。据我们所知，这是首例报告的颅颈交界区脊髓内结核瘤病例。随着发展中国家 MRI 的普及，现在临床医生无需进行活检即可诊断这种疾病。发达国家的临床医生应高度怀疑脊髓内结核瘤，因为 HIV 大流行导致中枢神经系统结核病再次出现。
