1/16. Spinal subdural tuberculous abscess.OBJECTIVES: Spinal subdural abscess is rare and only 48 cases have been described to date. In this report, we present an additional spinal subdural tuberculous abscess. METHOD: Tuberculous meningitis was diagnosed with clinical and laboratory findings in a 45-year-old man. A spinal subdural abscess was demonstrated using MRI. Presence of the abscess was revealed by surgical intervention. The diagnosis was confirmed by pathological examination. RESULTS: The patient had been treated for tuberculous meningitis 2 years previously. The disease recurred when anti-tuberculous therapy was prematurely discontinued. During the second treatment, the patient also underwent a ventriculo-peritoneal shunt operation for hydrocephalus. dizziness and weakness of both legs developed after the postoperative period. Spinal MRI showed a spinal subdural abscess as a iso-intense mass with spinal cord in the T1 and T2 weighted images, ring like enhancement and compression on the spinal cord at T3-T4 level. The patient underwent surgery and the abscess was drained. CONCLUSION: tuberculosis may cause a spinal subdural abscess and although it is a rare disorder, when encountered MRI is very useful in the diagnosis.- - - - - - - - - - ranking = 1keywords = dura (Clic here for more details about this article) |
2/16. Tuberculous radiculomyelitis complicating tuberculous meningitis: case report and review.Tuberculous radiculomyelitis (TBRM) is a complication of tuberculous meningitis (TBM), which has been reported rarely in the modern medical literature. We describe a case of TBRM that developed in an human immunodeficiency virus (hiv)-infected patient, despite prompt antituberculous treatment. To our knowledge, this is the second case of TBRM reported in an hiv-infected patient. We also review 74 previously reported cases of TBRM. TBRM develops at various periods after TBM, even in adequately treated patients after sterilization of the cerebrospinal fluid (CSF). The most common symptoms are subacute paraparesis, radicular pain, bladder disturbance, and subsequent paralysis. CSF evaluation usually shows an active inflammatory response with a very high protein level. MRI and CT scan are critical for diagnosis, revealing loculation and obliteration of the subarachnoid space along with linear intradural enhancement. As in other forms of paradoxical reactions to antituberculous treatment, there is evidence that steroid treatment might have a beneficial effect.- - - - - - - - - - ranking = 0.11111111111111keywords = dura (Clic here for more details about this article) |
3/16. 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 = 0.55555555555556keywords = dura (Clic here for more details about this article) |
4/16. Bilateral subdural effusion and subcutaneous swelling with normally functioning csf shunt.We report a child with hydrocephalus due to tuberculous meningitis who developed a subcutaneous fluid collection around the ventriculoperitoneal shunt tube entry point, after one month of shunting. On investigation, he had decompressed ventricles with bilateral fronto parietal subdural hygroma. Bifrontal burr hole drainage helped resolution of both subdural effusion and subcutaneous scalp swelling. This complication is unique and its pathogenesis has been postulated.- - - - - - - - - - ranking = 0.66666666666667keywords = dura (Clic here for more details about this article) |
5/16. 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 = 0.55555555555556keywords = dura (Clic here for more details about this article) |
6/16. Multiple meningeal tuberculomas recurring after 18-month anti-tuberculous chemotherapy--case report.A 26-year-old man with multiple intracranial masses widely attached to the dura presented with hypopituitarism and sexual impotence. magnetic resonance imaging showed the lesions were isointense on the T1-weighted and hypointense on the T2-weighted images, and involved the bilateral sphenoid ridges, the convexity, and tentorial incisura. The lesion was partially removed via the right pterional approach. Histological examination identified tuberculoma associated with giant cells and caseous necrosis. Although his neurological and radiological signs worsened paradoxically during anti-tuberculosis therapy, he recovered spontaneously upon continuation of the anti-tuberculous treatment. However, he suffered recurrence as tuberculous meningitis, after administration of anti-tuberculous therapy for 18 months. Additional anti-tuberculous treatment for 12 months stabilized the disease. tuberculoma should be included in the differential diagnosis of enhanced intracranial mass lesions. Anti-tuberculous therapy may require extended periods of up to 36 months to stabilize the disease.- - - - - - - - - - ranking = 0.11111111111111keywords = dura (Clic here for more details about this article) |
7/16. MRI of spinal intradural arachnoid cyst formation following tuberculous meningitis.Secondary intradural arachnoid cyst involving the spine is uncommon. It is usually secondary to trauma, haemorrhage, surgery or inflammation. We present two cases of treated tuberculous meningitis, which presented with gradual onset of quadriplegia and paraplegia, respectively. MRI revealed intradural (cervical and thoracic) arachnoid cysts (ventral and dorsal to the spinal cord) with myelomalacic cord changes. Ventral location of such spinal arachnoid cysts, and being secondary to tuberculous arachnoiditis are distinctively uncommon features. The rarity of this condition and the relevance of MRI in the accurate diagnosis have been discussed here.- - - - - - - - - - ranking = 0.66666666666667keywords = dura (Clic here for more details about this article) |
8/16. Tuberculous meningitis masked by delirium in an alcohol-dependent patient: a case report.OBJECTIVE: patients with alcohol dependence syndrome can present with delirium which will mask underlying organic causes for the delirium. However, other medical diseases can also present with similar symptoms and should not be missed. The issues related to differentiating the different causes of delirium are briefly discussed. We describe a case of tuberculous meningitis in a patient with history of alcohol dependence who presented with delirium. METHOD: A case report. RESULTS: A 38-year-old male was admitted with history of irrelevant talk and abnormal behaviour of 2-month duration. He was also disoriented and his short-term memory was impaired. He reported visual hallucinations. He had history of alcohol dependence of 5 years. A detailed mental status examination and neurological workup revealed an organic psychosis. CT scan showed a hypodense lesion suggestive of a tuberculoma. The cerebrospinal fluid findings were corroborative. He responded to antituberculous drugs which he took for one and a half years and recovered completely. He also underwent group therapy for his alcohol dependence and has since then refrained from alcohol intake. Currently he has gone back to his work as a car mechanic. CONCLUSION: We have highlighted the need for diagnosing and investigating carefully the cause of delirium in a patient with alcohol dependence syndrome. This shows that other curable causes of delirium must also be investigated in patients with alcohol dependence.- - - - - - - - - - ranking = 0.11111111111111keywords = dura (Clic here for more details about this article) |
9/16. Post-traumatic syringomyelia, an update.Post-traumatic and post-arachnoiditic syringomyelia is described in 31 patients from the Midland Centre for neurosurgery and neurology (MCNN). It is suggested that the mechanisms may be similar in the two groups and that treatment is best directed to disabling the likely filling mechanisms by opening up the cerebrospinal fluid (CSF) pathways and deliberately leaving the dura open to create an artificial meningocele. It is suggested that drainage on its own is inappropriate but that when drainage of the syrinx is chosen as an ancillary technique then syringopleural drainage may be the procedure of choice.- - - - - - - - - - ranking = 0.11111111111111keywords = dura (Clic here for more details about this article) |
10/16. Dural scrofula.A middle-aged woman presenting with multiple cranial neuropathies, hemiparesis, and CSF pleocytosis had tuberculous infection of the cranial dura mater at autopsy. This is the first description of dural scrofula in modern medical literature.- - - - - - - - - - ranking = 0.22222222222222keywords = dura (Clic here for more details about this article) |
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