1/43. Intramedullary tuberculoma of the spinal cord. Case report and review of the literature.Intramedullary spinal tuberculosis infection remains an extremely rare disease entity. In the most recent reviews only 148 cases have been reported in the world literature, although numerous recent reports from developing countries and on human immunodeficiency virus (hiv)-positive patients have increased this number. The authors present an unusual case of intramedullary tuberculoma in an hiv-negative patient from the southern united states who demonstrated no other signs or symptoms of tuberculosis infection. The authors believe that this is the first case of its kind to be presented in recent literature. The presentation of miliary disease via an isolated intramedullary spinal mass in a patient with no evident risk factors for tuberculosis infection emphasizes the importance of including tuberculosis in the differential diagnosis of spinal cord masses.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
2/43. Hypophyseal tuberculoma: direct radiosurgery is contraindicated for a lesion with a thickened pituitary stalk: case report.OBJECTIVE AND IMPORTANCE: Hypophyseal tuberculomas are extremely rare lesions. The recognition of hypophyseal tuberculomas in the differential diagnosis of pituitary tumors is important, even with no evidence of systemic tuberculosis. CLINICAL PRESENTATION: A 27-year-old female patient presented with continuous, dull, generalized headaches and amenorrhea, with no history of visual diminution, galactorrhea, or endocrinological abnormalities and no evidence of systemic tuberculosis. The patient exhibited a normal water balance, without polyuria or polydipsia. A gynecological examination, including an endometrial biopsy for amenorrhea, did not reveal any abnormalities. Perimetric and endocrinological examination results were normal. Contrast magnetic resonance imaging revealed a dense enhancing intrasellar mass, with thickening of the pituitary stalk. INTERVENTION: Sublabial rhinoseptal transsphenoidal decompression of the lesion was performed. The histopathological features were consistent with a diagnosis of tuberculoma, and acid-fast bacilli were demonstrated in the surgically removed tissue with Ziehl-Neelsen staining. As soon as the histopathological features were known, the patient underwent a lumbar puncture for cerebrospinal fluid analysis, which indicated normal findings. An intradermal tuberculin test yielded negative results. The patient was treated with medical therapy for 18 months, and complete resolution of the lesion was observed in follow-up examinations. CONCLUSION: Hypophyseal tuberculomas are often mistaken for pituitary adenomas. The finding of a thickened pituitary stalk in contrast magnetic resonance imaging scans may be useful for the differentiation of these lesions from pituitary adenomas. Direct radiosurgery is not an appropriate primary treatment method for pituitary adenomas and is principally restricted to elderly, medically unfit patients with microadenomas and patients with residual or recurrent tumors after microsurgery. It is contraindicated for patients who exhibit a thickened pituitary stalk in contrast magnetic resonance imaging scans.- - - - - - - - - - ranking = 0.14285714285714keywords = spinal (Clic here for more details about this article) |
3/43. Intradural extramedullary tuberculoma of the spinal cord: a case report.Intradural extramedullary (IDEM) tuberculoma of the spinal cord is uncommon entity and moreover, few reports have been documented on concurrent IDEM and intracranial tuberculomas. Authors report a case of IDEM spinal tuberculoma having intracranial lesion simultaneously. A 49-year-old woman suffered from paraparesis and urinary incontinence while being given medical treatment for tuberculous meningitis. magnetic resonance imaging (MRI) revealed an IDEM mass lesion between the T1 and T2 spinal levels, and multiple intracranial tuberculous granulomas. Surgical resection of the IDEM tuberculoma followed by anti-tuberculous medication resulted in good outcome.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
4/43. Intramedullary spinal tuberculoma: a case report.STUDY DESIGN: A case report showing an intramedullary thoracic spinal tuberculoma secondary to pulmonary tuberculosis in a 16-year-old patient with findings of subacute spinal cord compression. OBJECTIVES: The significance and the use of magnetic resonance imaging in the diagnosis of intramedullary tuberculoma, and the treatment of the patient that involves surgically the excision of intramedullary lesion followed by appropriate antituberculous therapy. SUMMARY OF BACKGROUND DATA: Tuberculomas of spinal cord are rare entities. The possibility of intramedullary tuberculoma should be seriously considered when an intraspinal mass is found, provided that pulmonary tuberculosis is present in the history of the patient. METHOD: Th4-Th5 laminectomy was performed. Intramedullary tuberculoma was excised through a myelotomy. Antituberculous treatment was applied after the surgery. RESULTS: Excellent clinical outcome was obtained with a combination of both medical and surgical treatments. CONCLUSION: The intramedullary spinal tuberculoma, although a rare entity, must be considered in the differential diagnosis of the spinal cord compression in patients with a history of tuberculosis, human immunodeficiency virus, and those who have a bad socioeconomic condition and bad nutrition habit. When confronted with a progressing neurologic deficit, a combination of microsurgical resection and antituberculous chemotherapy with the avoidance of steroids should be the choice of treatment for intramedullary tuberculomas.- - - - - - - - - - ranking = 1.4285714285714keywords = spinal (Clic here for more details about this article) |
5/43. Intramedullary tuberculoma of the conus medullaris: case report and review of the literature.OBJECTIVE: To illustrate the dilemmas in the diagnosis and management of intramedullary tuberculomas of the spinal cord. methods: Case report of a 32 year-old man with tuberculous meningitis. The presence of unexplained urinary retention and progressive weakness in the legs led to the discovery of an additional tuberculoma of the conus medullaris. SETTING: Dicle University Diyarbakir, turkey. RESULTS: The patient was on a 1-year course of isoniazid, pyrazinamide and rifampicin, and responded well to conservative treatment. Our patient's unique features were represented by the worsening of neurological symptoms while being treated with adequate anti-tuberculous medication. CONCLUSION: We present a case of intramedullary tuberculoma of the conus medullaris to illustrate the dilemmas in the diagnosis and management of this curable disease, and review of the literature to date.- - - - - - - - - - ranking = 0.14285714285714keywords = spinal (Clic here for more details about this article) |
6/43. Surgery for expansion of spinal tuberculoma during antituberculous chemotherapy: a case report.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.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
7/43. tuberculoma of the conus medullaris: case report.OBJECTIVE AND IMPORTANCE: Intramedullary spinal tuberculoma is a rare form of central nervous system tuberculosis. This article describes an affected patient who presented with left leg paresis. CLINICAL PRESENTATION: A 46-year-old man presented with a 7-day history of left leg weakness. The patient's medical history included infection with pulmonary tuberculosis 15 years previously, at which time he had been treated with antituberculosis therapy. The neurological examination performed at admission revealed left leg paresis with Grade 2/5 power in all muscle groups. The patient reported no urinary or bowel problems. INTERVENTION: Surgery was performed with the patient in the prone position. The procedure involved laminectomies at T11, T12, and L1, followed by a midline myelotomy. The mass was excised completely. Histopathological examination revealed a granulomatous lesion that contained Langhans' giant cells, inflammatory cells, and evidence of caseating necrosis. The patient was prescribed a 6-month course of antituberculosis therapy with pyrazinamide, isoniazid, and rifampin. CONCLUSION: The outcome was favorable. Recently, a number of authors have reported success with medical management of intraspinal tuberculoma. Intraspinal tuberculoma produces a mass effect that can jeopardize spinal cord function. The optimal treatment is a combination of microsurgical resection and antituberculosis chemotherapy.- - - - - - - - - - ranking = 0.57142857142857keywords = spinal (Clic here for more details about this article) |
8/43. Intradural, eextramedullary tuberculoma of the spinal cord as a complication of tuberculous meningitis.An unusual case of an intradural, extramedullary spinal cord tuberculoma, as a complication of tuberculous meningitis caused by a strain susceptible to major anti-TB drugs, is described in a previously healthy, hiv-negative, 27-year-old male. The tuberculoma was detected by magnetic resonance imaging (MRI) while the patient was under conventional anti-tuberculous (anti-TB) therapy. Histopathology confirmed the diagnosis. Despite the anti-TB treatment and the surgical resection, intramedullary spreading occurred. Finally, a favorable response was achieved by prolongation of treatment accompanied by the administration of ofloxacin and cycloserine.- - - - - - - - - - ranking = 0.71428571428571keywords = spinal (Clic here for more details about this article) |
9/43. Combined spinal subdural tuberculous empyema and intramedullary tuberculoma in an hiv-positive patient.Tuberculous involvement of the spinal subdural and intramedullary compartments is extremely uncommon. Simultaneous involvement of both compartments has never been reported, to our knowledge. We present an hiv-positive patient with such kind of combined involvement. diagnosis was made on the basis of a prior history of pulmonary tuberculous infection and a positive therapeutic response to antituberculous chemotherapy. magnetic resonance imaging is the diagnostic procedure of choice in order to determine the exact level, site, and size of the disease. tuberculosis of the spine should always be considered in the differential diagnosis of spinal cord compression if the patient lives in or comes from a region where tuberculosis is endemic or if the patient is immunocompromised.- - - - - - - - - - ranking = 0.85714285714286keywords = spinal (Clic here for more details about this article) |
10/43. Multiple tuberculomas in the brain and spinal cord: a case report.STUDY DESIGN: A case of disseminated tuberculoma in the spinal cord and brain is reported. OBJECTIVES: To present a case of disseminated tuberculoma in the spinal cord and brain and to describe the unusual pathologic features and clinical presentation. SUMMARY AND BACKGROUND: DATA Intramedullary tuberculoma concomitant with intracerebral disseminated tuberculoma is rare. Only one other case has been reported in the world literature. This represents the second reported case of this unusual lesion. MATERIALS AND methods: The authors report a 67-year-old man with miliary tuberculosis of the lung and started on antituberculous therapy. His pulmonary complaints were resolved, but he presented acute paraparesis caused by tuberculomas in the thoracolumbar spinal cord. MRI showed more tuberculomas in the brain stem, cerebellum, and cerebral hemispheres. RESULTS: After 6 months, the patient's muscle power gradually improved with a combination of medical and surgical management. CONCLUSIONS: Our experience indicates that antituberculous medication is effective in managing multiple central nervous system tuberculomas. The purpose of surgical intervention is to decompress the cord or brain when progressing neurologic defects occur and to examine the tissue pathologically.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
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