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Intramedullary Conus Medullaris Tuberculoma: A Case Report and Review of the Literature. Infect Dis Rep 2021; 13:82-88. [PMID: 33467582 PMCID: PMC7839007 DOI: 10.3390/idr13010010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 11/18/2022] Open
Abstract
Intramedullary tuberculoma (IMT) of the conus medullaris is extremely rare. We present a case of intramedullary conus medullaris tuberculoma in which the diagnosis was based on there being very high levels of adenosine deaminase (ADA) in the patient’s cerebrospinal fluid (CSF) and improvement with antituberculous therapy. A 78-year-old man presented after having had a dull ache in both thighs and progressive paraparesis. The patient’s medical history included diffuse large B-cell lymphoma, which had undergone remission due to chemotherapy two years earlier, and long-term, well-controlled diabetes. A chest X-ray showed no evidence of tuberculosis. The results of CSF analysis were compatible with Froin’s syndrome. An initial diagnosis was made of an intramedullary tumor of the conus medullaris, based on magnetic resonance imaging (MRI). A myelotomy and multiple punch out biopsy were performed, and histopathology of the tissues revealed mild reactive gliosis. Due to the patient having high levels of CSF-ADA, IMT of the conus medullaris was suspected. The patient was treated with an 18-month course of antituberculous therapy. The dull ache gradually disappeared, and motor power improved slightly. A follow-up MRI of the lumbosacral (LS) spine revealed that the lesion had completely disappeared. Intramedullary tuberculoma of the conus medullaris should be considered in patients with underlying malignancy and no symptoms of systemic tuberculosis. CSF adenosine deaminase levels can be helpful in determining the presence of central nervous system tuberculosis when other systemic signs of disease are lacking.
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A rare case of disseminated tuberculosis; multiple intracranial and intramedullary tuberculomas with concurrent tuberculous spondylitis and meningitis. J Clin Tuberc Other Mycobact Dis 2020; 20:100169. [PMID: 32548312 PMCID: PMC7286962 DOI: 10.1016/j.jctube.2020.100169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Concomitant presentation of intracranial and intramedullary tuberculomas is a rare entity. We report a 38-year-old immunocompetent woman with intramedullary and intracranial tuberculomas with concurrent tuberculous spondylitis and meningitis, who presented with paraparesis and back pain. Despite initial antituberculous therapy, the patient’s neurologic status deteriorated with the development of paraplegia. Following surgical intervention, the patient gradually recovered muscle strength and bladder function.
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Marais S, Roos I, Mitha A, Mabusha SJ, Patel V, Bhigjee AI. Spinal Tuberculosis: Clinicoradiological Findings in 274 Patients. Clin Infect Dis 2019; 67:89-98. [PMID: 29340585 DOI: 10.1093/cid/ciy020] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/10/2018] [Indexed: 12/14/2022] Open
Abstract
Background Mycobacterium tuberculosis is a major cause of myelopathy and radiculopathy in settings with a high prevalence of tuberculosis/human immunodeficiency virus (HIV) coinfection. However, a paucity of publications exists on the spectrum of neurological and magnetic resonance (MR) imaging findings of spinal tuberculosis in these populations. Methods We conducted a retrospective study of adults with spinal tuberculosis at a referral center in South Africa for patients with spinal disease without bony involvement seen at plain film radiography. We report the clinical, laboratory and spinal MR imaging findings, compare HIV-infected and HIV-uninfected patients, and correlate clinical and cerebrospinal fluid findings with those of MR imaging. Results Of 274 patients, 209 (76%) were HIV infected and 49 (18%) were HIV uninfected. Radiculomyelitis occurred in 77% (n = 210), and spondylitis in 39% (n = 106). Subdural abscess (n = 42) and intramedullary tuberculoma (n = 33) were common. In 24% of HIV-infected and 14% of HIV-uninfected patients, spinal disease manifested as a paradoxical tuberculosis reaction, frequently following tuberculous meningitis. The triad of neurological deficit, fever, and back pain was similar in patients with spondylitis (24%), epi/subdural abscess without bony disease (14%), meningoradiculitis (17%), and isolated myelitis (17%) . Conclusions Radiculomyelitis is a common manifestation of spinal tuberculosis in settings with high tuberculosis/HIV prevalence, often presenting as a paradoxical reaction. We describe a high frequency of rarely reported spinal tuberculosis manifestations, suggesting that these are more common than implied by the literature.
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Affiliation(s)
- Suzaan Marais
- Department of Neurology, Inkosi Albert Luthuli Central Hospital, Durban, South Africa.,Department of Neurology, University of KwaZulu-Natal, Durban, South Africa
| | - Izanne Roos
- Department of Neurology, Inkosi Albert Luthuli Central Hospital, Durban, South Africa.,Department of Neurology, University of KwaZulu-Natal, Durban, South Africa
| | - Ayesha Mitha
- Department of Radiology, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | | | - Vinod Patel
- Department of Neurology, Inkosi Albert Luthuli Central Hospital, Durban, South Africa.,Department of Neurology, University of KwaZulu-Natal, Durban, South Africa
| | - Ahmed I Bhigjee
- Department of Neurology, Inkosi Albert Luthuli Central Hospital, Durban, South Africa.,Department of Neurology, University of KwaZulu-Natal, Durban, South Africa
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Zheng X, Wu X. Diagnosis and Management of Intraspinal Tuberculoma with Giant Paraspinal Abscesses. World Neurosurg 2019; 127:481-484. [PMID: 31029821 DOI: 10.1016/j.wneu.2019.04.157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/16/2019] [Accepted: 04/17/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Although tuberculosis is rare in the west, in recent years, it's becoming more and more common in China. Intraspinal tuberculoma is extremely rare, but it's an important cause of morbidity. Magnetic resonance imaging scanning is an effective method for the diagnosis of intraspinal tuberculoma. CASE DESCRIPTION This case report shows an intraspinal tuberculoma with giant paraspinal abscesses in a 28-year-old female patient with subacute progressing neurologic deficit. L1-L5 laminectomy was performed, followed by extensively excision of intraspinal and paraspinal lesion. Antituberculous treatment was carried out after pathologic diagnosis. An excellent clinical outcome was obtained. Within 24 hours of the surgical procedure, muscle weakness in both lower extremities started to improve. Three days later, the patient felt muscle strength recovered significantly, with grade 4/5 in the lower limbs in 2 weeks. Six weeks later, the patient was able to walk without assistance. CONCLUSIONS The case was treated by surgical excision of an intraspinal and a paraspinal lesion followed by normal quadruple antituberculous therapy. Although intraspinal tuberculoma is a rare entity, it can be effectively diagnosed on the basis of magnetic resonance imaging scanning and treated by the combination of medical and surgical treatments.
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Affiliation(s)
- Xiaodan Zheng
- Department of Stomatology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinghuo Wu
- Department of Orthopaedic Surgery, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Ghali MGZ, Srinivasan VM, Kim MJ, Malik A. Spinal Intramedullary Tuberculosis with Concurrent Supra- and Infratentorial Intracranial Disease in a 9-Month-Old Boy: Case Report and Comprehensive Review of the Literature. World Neurosurg 2017; 106:37-45. [PMID: 28532916 DOI: 10.1016/j.wneu.2017.05.069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 05/09/2017] [Accepted: 05/11/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Tuberculous involvement of the spinal cord parenchyma is an exceedingly rare clinical entity; even more so is concurrent intracranial tuberculosis (TB). Spinal intramedullary TB presents with a characteristic subacute myelopathy, with slowly progressive paraplegia, sensory deficits, and/or bowel and bladder dysfunction. Diagnosis is strongly suspected with a clinical history of known TB in conjunction with characteristic findings on magnetic resonance imaging. Management involves multiagent antitubercular chemotherapy without or with operative intervention. CASE DESCRIPTION We present a case of a 9-month-old boy with a retrospectively recognized history of pulmonary TB presenting with fever and back tenderness found to have lower-extremity hypertonia and clonus. Imaging revealed concurrent intracranial and spinal intramedullary tuberculomas. The patient was treated for hydrocephalus with external ventricular drainage followed by T8-T10 laminectomy, drainage of abscess, and duraplasty. Parietal lobe biopsies proved the tuberculous etiology of intracranial lesions. CONCLUSION Etiopathogenesis, diagnosis, and management considerations of spinal intramedullary tuberculosis are reviewed and discussed.
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Affiliation(s)
- Michael George Zaki Ghali
- Department of Neurobiology & Anatomy, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA; Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
| | | | - Marc J Kim
- Department of Internal Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Archana Malik
- Department of Pediatric Radiology, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania, USA
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Mizuno Y, Doi A, Endo A, Nishioka H. Streptococcus pneumoniae Meningitis Presenting with Acute Urinary Retention and Emphysematous Cystitis. Intern Med 2016; 55:2101-4. [PMID: 27477423 DOI: 10.2169/internalmedicine.55.6325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A combination of acute urinary retention and aseptic meningitis has occasionally been described, which is referred to as meningitis-retention syndrome. In contrast, acute urinary retention has rarely been reported in bacterial meningitis. We herein report a case of Streptococcus pneumoniae meningitis presenting with acute urinary retention which led to emphysematous cystitis in an elderly woman. She presented with impaired consciousness and a distended lower abdomen. She was diagnosed with pneumococcal meningitis by lumbar puncture. Abdominal computed tomography revealed the presence of emphysematous cystitis. She completely recovered with antibiotic therapy without any complications. Acute urinary retention can occur secondary to pneumococcal meningitis.
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Affiliation(s)
- Yasushi Mizuno
- Department of General Internal Medicine, Kobe City Medical Center General Hospital, Japan
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Abstract
Background:Intravascular large cell lymphoma (ILCL) is a diagnostic challenge, with neurological, cutaneous and constitutional symptoms. The natural history is usually an evolution to a comatose state. As invasive procedures are usually required for diagnosis, recognizing the typical clinical pattern is critical since an effective treatment is available.Method:After an extensive literature review of the subject, we report a case of ILCL, analyzing clinical, laboratory, radiological and pathological data. We will also give a special attention to the clinical picture of a conus medullaris (CM) lesion with subsequent encephalopathy in the same patient.Results:We report here a 61-year-old woman with a paraplegia caused by a CM lesion, evolving about one year latter to encephalopathy and eventual coma, with the diagnosis of ILCL confirmed by autopsy. The present case is similar to eight other cases in literature who had CM lesion associated with ILCL, knowing that 80-90% of these patients will eventually evolve to encephalopathy without treatment. Conclusions: ILCL is a recognized but rare cause of coma. Diagnosing it is tremendously important since it is fatal if left untreated. We propose that this specific picture (conus medullaris lesion, eventually evolving to encephalopathy) is quite characteristic and will directly result in better outcome if recognized.
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Garg RK, Malhotra HS, Kumar N. Paradoxical reaction in HIV negative tuberculous meningitis. J Neurol Sci 2014; 340:26-36. [PMID: 24680563 DOI: 10.1016/j.jns.2014.03.025] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 02/21/2014] [Accepted: 03/12/2014] [Indexed: 01/06/2023]
Abstract
This review focusses on paradoxical reactions occurring during the treatment of tuberculous meningitis (TBM) in human immunodeficiency virus-negative cases. A paradoxical reaction is defined as the worsening of a pre-existing lesion or the appearance of new lesion in a patient whose clinical symptoms initially improved with anti-tuberculosis treatment. A number of different paradoxical reactions have been reported in patients with TBM including expansion of existing cerebral tuberculomas, and appearance of new tuberculomas, hydrocephalus, and optochiasmatic and spinal arachnoiditis. While the exact mechanism of paradoxical reactions is uncertain, an exaggerated immune reaction against Mycobacterium tuberculosis-associated antigens is currently the most accepted theory for tuberculous paradoxical reaction. Corticosteroids are considered to have a beneficial effect in the management of paradoxical reactions. Immuno-modulatory drugs, including tumor necrosis factor-α antagonists, thalidomide and interferon-γ have been used in isolated cases with more severe forms of paradoxical reactions.
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Affiliation(s)
- Ravindra Kumar Garg
- Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
| | | | - Neeraj Kumar
- Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India
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An Intramedullary Tuberculous Abscess of the Conus in a 5-Year-Old Child Presenting with Urinary Dysfunction. World Neurosurg 2011; 76:592.e15-8. [DOI: 10.1016/j.wneu.2011.01.045] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 11/18/2010] [Accepted: 01/26/2011] [Indexed: 11/21/2022]
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Tuberculome du cône médullaire : à propos d’un cas et revue de la littérature. Rev Mal Respir 2011; 28:696-9. [DOI: 10.1016/j.rmr.2011.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Accepted: 09/26/2010] [Indexed: 11/24/2022]
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Diagnostic et traitement d’un tuberculome intramédullaire : quelle place pour la neurochirurgie ? Presse Med 2011; 40:314-6. [DOI: 10.1016/j.lpm.2010.10.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 09/16/2010] [Accepted: 10/15/2010] [Indexed: 11/18/2022] Open
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Jira M, El Qatni M, Sekkach Y, Elomri N, Ghafir D, Zerhouni A, Mounach J. Une paraparésie fébrile. Rev Med Interne 2010; 31:506-7. [DOI: 10.1016/j.revmed.2009.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Accepted: 08/17/2009] [Indexed: 10/19/2022]
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Tuberculome du cône médullaire : à propos d’un cas et revue de la littérature. Neurochirurgie 2009; 55:561-4. [DOI: 10.1016/j.neuchi.2008.08.110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Accepted: 08/05/2008] [Indexed: 11/23/2022]
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Korri H, Awada A. Tuberculose miliaire et tuberculome intramédullaire du cône terminal. Rev Neurol (Paris) 2007; 163:1106-8. [DOI: 10.1016/s0035-3787(07)74186-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Affiliation(s)
- Christopher A Robinson
- Department of Pathology, Royal University Hospital and Saskatoon Health Region, Saskatoon, Saskatchewan, Canada
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Skoglund TS, Nilsson D. Tumor of the conus medullaris treated with antituberculous therapy. Clin Neurol Neurosurg 2007; 109:192-4. [PMID: 16962232 DOI: 10.1016/j.clineuro.2006.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2006] [Revised: 07/02/2006] [Accepted: 08/01/2006] [Indexed: 11/20/2022]
Abstract
This case report concerns a 21-year-old man developing left leg paresis. Evaluation with magnetic resonance imaging (MRI) showed an intramedullary tumor in the conus region. He was planned for surgery but preoperative investigation indicated he had tuberculosis and the tumor was presumed to be a tuberculoma. Antituberculous therapy was started and the patient improved neurologically. The patient was followed clinically and with consecutive MRI during 2 years and the last MRI showed that the lesion had disappeared completely. Intramedullary tuberculomas are rare but important differential diagnosis in patients with spinal cord mass lesions. The role of medical and surgical treatment of intramedullary tuberculomas is discussed.
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Affiliation(s)
- Thomas S Skoglund
- Department of Neurosurgery, Sahlgrenska University Hospital, Blå Stråket 7, S-413 45 Göteborg, Sweden.
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Jaiswal AK, Jaiswal S, Gupta SK, Singh Gautam VK, Kumar S. Intramedullary tuberculoma of the conus. J Clin Neurosci 2006; 13:870-2. [PMID: 16931024 DOI: 10.1016/j.jocn.2005.11.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2005] [Accepted: 11/24/2005] [Indexed: 11/21/2022]
Abstract
We present a conus medullaris tuberculoma in a 12-year-old girl. She presented with low backache, weakness of both lower limbs and urinary disturbance. Magnetic resonance imaging revealed a D10-L1 intramedullary mass. The tumour was excised and the biopsy was suggestive of tuberculoma. The patient received antituberculous therapy postoperatively and improved. The relevant literature is discussed briefly.
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Luo L, Pino J. An intradural extramedullary tuberculoma of the spinal cord in a non-HIV-infected patient: case report and review of the literature. Lung 2006; 184:187-93. [PMID: 16902844 DOI: 10.1007/s00408-005-2579-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2005] [Indexed: 10/24/2022]
Abstract
Spinal tuberculomas are extrapulmonary manifestations of tuberculosis involving the central nervous system. They are characterized as extradural, intradural extramedullary, or intradural, according to their location. Intradural extramedullary tuberculomas are extremely rare. There have been only 24 case reports found in English language literature. Our case is the only documented intradural extramedullary tuberculoma in a non-HIV-infected patient in North America. A literature review using a Medline search from 1966 to the present is performed to characterize the clinical spectrum of the three types of tuberculomas and review the diagnosis and management of this potentially curable disease. An analysis of the cases of intradural extramedullary tuberculomas published since 1984 is performed to highlight the unique characteristics of this rare disease.
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Affiliation(s)
- Lan Luo
- Department of Internal Medicine, Coastal AHEC, University of North Carolina School of Medicine, 2131 South 17th Street, Wilmington, NC 28409, USA.
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Wasay M, Arif H, Khealani B, Ahsan H. Neuroimaging of Tuberculous Myelitis: Analysis of Ten Cases and Review of Literature. J Neuroimaging 2006; 16:197-205. [PMID: 16808820 DOI: 10.1111/j.1552-6569.2006.00032.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
We retrospectively reviewed the clinical and neuroimaging features of 10 patients with tuberculous myelitis. The most common presenting symptoms were fever (70%) and paraplegia (60%). Bladder and bowel symptoms were present in 90% patients. On MRI, the involvement of the cervical/thoracic segment of the spinal cord was most commonly seen (90%). The most consistent finding was hyperintense signals on T2-weighted MRI. T1-weighted images showed isointense (n= 5) and hypointense (n= 4) signals in the spinal cord lesions. Post-contrast enhancement was present in 6 patients, epidural enhancement in 4 patients, and cord swelling in 2 patients. We reviewed more than 250 published cases with the diagnosis of tuberculous myelitis and radiculomyelitis with special attention to MRI findings. It is predominantly a disease of the thoracic spinal cord. Most spinal cord lesions appear as hyperintense on T2 and iso- or hypointense on T1-weighted images. MRI findings in patients with spinal cord tuberculosis have both diagnostic and prognostic significance. Cord atrophy or cavitation and the presence of syrinx on MRI may be associated with poor outcome.
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Affiliation(s)
- Mohammad Wasay
- Department of Neurology, The Aga Khan University, Stadium Road, Karachi 74800, Pakistan.
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Nas K, Kemaloğlu MS, Cevik R, Ceviz A, Necmioğlu S, Bükte Y, Cosut A, Senyiğit A, Gür A, Saraç AJ, Ozkan U, Kirbaş G. The results of rehabilitation on motor and functional improvement of the spinal tuberculosis. Joint Bone Spine 2004; 71:312-6. [PMID: 15288857 DOI: 10.1016/s1297-319x(03)00135-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2002] [Accepted: 04/14/2003] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To evaluate the result of rehabilitation on motor and functional improvement in spinal tuberculosis. METHOD Prospective case study. Data were collected from 47 patients with spinal tuberculosis medically and/or surgically treated, and rehabilitated over 6 months of period, after spinal decompression and fusion. The main outcome measures were motor development of the patients who were evaluated at the beginning, in the 1st week, in the 3rd month, and in the 6th month. Functional development of the patients was evaluated at the beginning and in the 6th month. Functional assessment was made according to Modified Barthel Index (MBI), and motor examination was made according to American Spinal Injury Association (ASIA). RESULTS The study population consisted of 47 patients (22 males and 25 females) mean aged 37.9 +/- 18.3 years (range 5-76 years). The most common site of spinal tuberculosis was the thoracic region. Localized back pain, paraparesis, sensory dysfunction and fever were typical clinical manifestations. Surgical management was performed as anterior or posterior drainage of abscess and/or stabilization of the spine. The rehabilitation program was performed in all patients during the preoperative, early postoperative and late postoperative 6 month periods. Muscle-strengthening exercises on necessary localization such as pectoral, abdominal, lower extremities; truncal and sacrospinal extensors were started for the rehabilitation. The motor score for the lower limbs and the MBI scores for activities of daily living (ADL) and mobility improved significantly (P < 0.001). The self-care and mobility categories of the MBI on admission; were 14.8% severely dependent and 10.6% independent. However, at the end of the rehabilitation program, 4.2% were severely dependent and 70.2% independent. IN CONCLUSION Early diagnosis and appropriate medical and/or surgical treatment together with a rehabilitation program will improve the life quality of patients with spinal tuberculosis.
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Affiliation(s)
- Kemal Nas
- Physical Medicine and Rehabilitation, Dicle University School of Medicine, Diyarbakir, Turkey.
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