Surgery for Expansion of Spinal Tuberculoma during Antituberculous Chemotherapy: A Case ReportNomura S. · Akimura T. · Kitahara T. · Nogami K. · Suzuki M.
Department of Neurosurgery, Yamaguchi University School of Medicine, Ube, Japan
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
We report a case of intramedullary spinal tuberculoma in a girl aged 2 years and 6 months. At the age of 18 months, the patient was hospitalized for 2 months with tuberculous meningitis. Tuberculomas then appeared in the thoracic spinal cord, and the patient developed paraparesis despite continuation of chemotherapy. Spinal magnetic resonance imaging demonstrated multiple ring-enhanced lesions in the cord on the T1-weighted image; on the T2-weighted image, the lesions had a bright core surrounded by a hypointense rim. Laminectomy and partial excision were performed, and the paraparesis improved. In addition to antituberculous chemotherapy and dexamethasone, surgical decompression was needed to treat the expansion of the spinal tuberculoma.
© 2001 S. Karger AG, Basel
- Gropper MR, Schulder M, Duran HL, Wolansky L: Cerebral tuberculosis with expansion into brainstem tuberculoma. Report of two cases. J Neurosurg 1994;81:927–931.
- Dao DA, Lee PW, Roy TM: Intracranial tuberculoma. J Ky Med Assoc 1990;88:121–124.
Bucy P, Oberhill H: Intradural spinal granulomas. J Neurosurg 1950;7:1–12.
- Hejazi N, Hassler W: Multiple intracranial tuberculomas with atypical response to tuberculostatic chemotherapy: Literature review and a case report. Infection 1997;25:233–239.
- Hejazi N, Hassler W: Multiple intracranial tuberculomas with atypical response to tuberculostatic chemotherapy: Literature review and a case report. Acta Neurochir (Wien) 1997;139:194–202.
Chambers ST, Hendrickse WA, Record C, Rudge P, Smith H: Paradoxical expansion of intracranial tuberculomas during chemotherapy. Lancet 1984;ii:181–184.
- Teoh R, Humphries M, O’Mahony G: Symptomatic intracranial tuberculoma developing during treatment of tuberculosis: A report of 10 patients and review of the literature. Q J Med 1987;63:449–460.
Tokuda H: Current status of tuberculosis in Japan. Jpn J Diagn Imaging 2000;20:954–956.
- Garcia MJ: Central nervous system tuberculosis. Neurol Clin 1999;17:737–759.
Wadia N: Radiculomyelopathy associated with spinal meningitides (arachnoiditis) with special reference to the spinal tuberculous variety; in Spillane J (ed): Tropical Neurology. London, Oxford University Press, 1973, pp 63–65.
- Dastur D, Wadia N: Spinal meningitides with radiculo-myelopathy. 2. Pathology and pathogenesis. J Neurol Sci 1969;8:261–297.
- Kalita J, Mistra UK: Intramedullary cervical tuberculoma. Spinal Cord 1999;37:297–298.
- Kato M, Mochizuki T, Negaro K, Fukusako T, Nogaki H, Morimatsu M: Magnetic resonance imaging of a case of central nervous system tuberculosis with tuberculous arachnoiditis and multiple tuberculomas (in Japanese). Nippon Ronen Igakkai Zasshi 1997;34:818–824.
- Yonemura K, Teramoto H, Honda I, Hashimoto Y, Uchino M: A case of intracranial tuberculoma followed by MRI (in Japanese). Rinsho Shinkeigaku 1998;38:32–37.
- Kioumehr F, Dadsetan MR, Rooholamini SA, Au A: Central nervous system tuberculosis: MRI. Neuroradiology 1994;36:93–96.
- Gupta RK, Gupta S, Kumar S, Kohli A, Misra UK, Gujral RB: MRI in intraspinal tuberculosis. Neuroradiology 1994;36:39–43.
- Rao GP, Nadh BR, Hemaratnan A, Srinivas TV, Reddy PK: Paradoxical progression of tuberculous lesions during chemotherapy of central nervous system tuberculosis. J Neurosurg 1995;83:359–362.
- Nozaki H, Takashima S, Ishihara T, Aoyagi T: Paradoxical expansion of intracranial tuberculomas during chemotherapy (in Japanese). Rinsho Shinkeigaku 1992;32:91–93.
- Nussbaum ES, Rockswold GL, Bergman TA, Erickson DL, Seljeskog EL: Spinal tuberculosis: A diagnostic and management challenge. J Neurosurg 1995;83:243–247.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.