Title: Intra Medullary Tuberculoma Presenting as Brown Sequard Syndrome with Concurrent Intradural Extramedullary Tuberculoma and Arachnoiditis
Authors: Pratibha Prasad, Amita Bhargava, Khichar Shubhakaran
DOI: https://dx.doi.org/10.18535/jmscr/v6i2.97
Abstract
Intramedullary and intradural-extramedullary spinal tuberculomas causing spinal cord compression is an uncommon entity. We report an unique case of a 27-year-old Indian male patient on 4 drug antituberculous chemotherapy for tubercular meningitis , who presented after two months with rapidly progressive unilateral lower limb monoparesis with loss of pain and temperature in the contralateral limb but intact position and vibration sense. MRI spine showed a single intramedullary tuberculoma at D2-D3 level, might causing brown sequard syndrome, associated with multiple intradural-extramedullary tuberculomas in thoracic and cervical region with arachnoiditis. MRI brain showed no evidence of intracranial tuberculoma. In our case the patient was given high dose steroid to which he responded and later discharged on antituberculous therapy and oral steroids. This case is being reported owing to its rarity of its presentation as brown sequard syndrome and co-occurrence of both intramedullary and intradural-extramedullary tuberculomas in an immunocempetent patient.
Keywords: Intramedullary, Intradural-extramedullary Tuberculoma, Brown-Sequard-Syndrome
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