Verma Aman, Olkha Vikas, Sethy Siddharth Sekhar, Verma Vishal, Goyal Nikhil, Kandwal Pankaj
Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India.
JBJS Case Connect. 2024 Nov 14;14(4). doi: e24.00266. eCollection 2024 Oct 1.
A 47-year-old man presented with neck pain, restricted neck movements, along with involvement of facial and hypoglossal nerve. On the basis of clinico-radiological correlation, the patient was diagnosed with craniovertebral junction tuberculosis and was started on antitubercular therapy (ATT). Failing the conservative trial, the patient was operated and occipitocervical fusion was done with bone grafting. After 12 months of ATT intake, he showed complete recovery of the facial and hypoglossal nerve, with complete resolution of instability pain.
Craniovertebral junction tuberculosis is uncommon, and its manifestation with cranial nerves involvement is even more rare. Meticulous clinico-radiological assessment should be done to diagnose and plan the treatment. Early recognition and prompt initiation of ATT, along with timely surgical intervention, when necessary, are crucial for optimal management and outcomes.
一名47岁男性，出现颈部疼痛、颈部活动受限，同时伴有面神经和舌下神经受累。基于临床与影像学的相关性，该患者被诊断为颅颈交界区结核，并开始接受抗结核治疗（ATT）。保守治疗试验失败后，患者接受了手术，并进行了枕颈融合及植骨。在接受ATT治疗12个月后，他的面神经和舌下神经完全恢复，不稳定疼痛也完全消失。
颅颈交界区结核并不常见，伴有颅神经受累的表现更为罕见。应进行细致的临床与影像学评估以诊断并规划治疗方案。早期识别并及时启动ATT，以及在必要时及时进行手术干预，对于实现最佳管理和治疗效果至关重要。
