Daif A K, al Rajeh S, Ogunniyi A, al Boukai A, al Tahan A
Division of Neurology and Radiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Can J Neurol Sci. 1997 Feb;24(1):73-6. doi: 10.1017/s0317167100021156.
Tuberculosis of the nervous system has protean manifestations. Syringomyelia, though an uncommon complication of it, is usually of late onset.
We report two patients with tuberculosis meningitis who developed syringomyelia acutely. The diagnosis was supported by neuroimaging and findings at laminectomy.
The two patients developed syringomyelia between 11 days and 6 weeks of the onset of tuberculous meningitis. They both had cord swelling and softening.
Acute-onset syringomyelia should be suspected in any patient being treated for tuberculosis meningitis who subsequently develops limb weakness and/or sphincteric dysfunction. Inflammatory edema and cord ischemia appeared to be the underlying mechanisms in these early onset cases rather than arachnoiditis which is important in late-onset cases.
神经系统结核有多种表现形式。脊髓空洞症虽是其罕见并发症，但通常起病较晚。
我们报告了2例急性发生脊髓空洞症的结核性脑膜炎患者。神经影像学检查及椎板切除术结果支持该诊断。
这2例患者在结核性脑膜炎发病后11天至6周出现脊髓空洞症。他们均有脊髓肿胀和软化。
任何正在接受结核性脑膜炎治疗且随后出现肢体无力和/或括约肌功能障碍的患者，均应怀疑急性起病的脊髓空洞症。在这些早期发病病例中，炎症性水肿和脊髓缺血似乎是潜在机制，而非在晚期发病病例中起重要作用的蛛网膜炎。
