1
Review of published literature regarding spinal cord involvement in patients with tuberculous meningitis
SS
S.
No.
Author,
year
Type of
study
1
Ransome
and
Montiero
1947
Case
reports (4
patients)
2
Brooks et
al 1954
Case
series of
80
patients of
TBM
3
Jenkins
1963
Case
report
4
Gomez &
Ziegler,
1966
Kocen
and
Parsons
1970
5
Age/Se
x
(age in
years)
Adults
(age
and
sex not
mentio
ned)
75
patient
s >10
years
old
Initial
diagnosis
Duration since TBM and
spinal manifestation
Fever of
unknown
origin, later
diagnosed
as TBM
Paraparesis, urinary
incontinence
TBM
After variable duration,
Paraparesis and
bowel/bladder involvement
61M
TBM
Bladder/bowel symptoms
Case
report
26F
TBM
Case
series of
18
patients (1
had spinal
manifestat
ion after
TBM)
24F
TBM
Flaccid paraparesis (T1011) developed after 5
months
Paraplegia developed 6
weeks after TBM (later on
incontinence of urine)
Manifestation/s
Biochemical
Froin's syndrome
(CSF protein 900
mg/dl)
Neuroimaging
Type of spinal
cord
involvement
Treatment
Outcome
Not done
Extensive
arachnoiditis
on autopsy
Not
mentioned
All died
Not known
Not done
10 patients had
transverse
myelitis; 15
had spinal
block
38
patients
died;
Polymorphonuclear
pleocytosis
Air Myelography
Biopsy
Chronic
adhesive
arachnoiditis
Radiculomyelit
is
Patients of
spinal block
received
intrathecal
streptomyci
n
ATT
ATT
Recovere
d
ATT and
corticosteroi
ds
Improved
Myelography
CSF cell 277/µl
and CSF protein
350 mg/dl (later
5000 mg/dl)
Not done (CSF manometry
showed spinal block)
Intradural
lesion
Improved
2
6
GiménezRoldán et
al 1974
Case
reports
33M
TBM in
early
infancy
After 13 years, paraparesis
Air ventriculography
demonstrated marked
hydrocephalus; Syringomyelia
in cervical an thoracic region,
extensive thick arachnoid
adhesions
Syrinx,
arachnoiditis
Died
after
surgery
28M
TBM at the
age 18
atrophy of the hands and
paraparesis
Myelography showed
Fragmentation and multilevel
blockage; Syringomyelia in
cervical and thoracic region
Spinal block
and syrinx
ventriculoatrial
shunting
procedure
Remaine
d
unchange
d
46F
TBM at the
age 26
Progressive atrophy of left
hand followed by paresis
of her left leg. Two years
later the right leg was
affected.
Myelography showed Block at
the T8 level with spinal
arachnoiditis. The spinal canal
was slightly enlarged in the
cervical and thoracic regions.
Arachnoiditis
and spinal
block
A
ventriculoatrial shunt
Remaine
d
unchange
d
Myelography showed a
complete block at the T 6
level, highly suggestive of
spinal arachnoiditis: blindness
arachnoiditis
Debridemen
t of thoracic
cord
Further
deteriorat
ed
Air myelogram
Arachnoiditis,
Syringomyelia
Intrathecal
ATT at time
of TBM
diagnosis(15
year back)
Not
improved
.
7
Savoiardo
1976
Case
report
26F
TBM at the
age 10
39M
TBM 15
year back
Severe spastic
quadriparesis evolving
over a period of 8 years.
Sensation for pin-prick and
temperature was absent in
the C 2 to T 6 dermatomes.
Quadriparesis (spastic
paraplegia in lower limbs
since 15 year and gradually
progressive flaccid
weakness in upper limbs
Normal CSF at
time of upper limb
weakness
3
8
9
Freilich
and
Swash
1979
De
Bruyne et
al 1983
Case
reports
Case
series
later on)
3months,
areflexic paraparesis
34F
TBM
58M
TBM
Initial manifestation,
a flaccid areflexic
paraparesis, both plantar
were extensor
29F
TBM
Initial manifestation,
areflexic paraparesis
24M
Pulmonary
tuberculosi
s and TBM
2 years while on ATT,
flaccid areflexic
paraparesis, both plantar
were extensor
Myelogram showed complete
obstruction at 11th thoracic
vertebra because of
subarachnoid granuloma
48M
TBM
Initial manifestation,
flaccid paraparesis
Normal myelogram
61M
TBM by
CSF
Initial manifestation,
flaccid paraparesis
46M
Acute
meningoen
cephalitis
with
radiculomy
elitis
Chronic
meningoen
cephalitis
Residual
meningoen
Not known
Not known
myelogram
showed a filling defect at the
L5/SI disc, and thickening of
all the
lower lumbar and sacral nerve
roots
Biopsy
(cauda equine exudates)
Not known
Not known
Not known
Not known
64F
45F
Plain radiographs and a
myelogram were normal
ATT and
corticosteroi
ds
ATT and
corticosteroi
ds
Improved
ATT
Improved
ATT and
surgery
Improved
ATT
Improved
Arachnoiditis
ATT and
corticosteroi
ds and
decompressi
on
Improved
Arachnoiditis
Not known
Died
Biopsy
(cauda equine exudates)
Arachnoiditis
ATT
Died
Biopsy
Spinal
meningeal
ATT
Died
Not done
The CSF protein
was
25 g/l.
collapse of the body of the
fifth lumbar vertebra
Arachnoiditis
Improved
4
10
Vlcek et
al 1984
Case
report
73F
11
Chang et
al 1989
Case
series of
13
patients
10
patient
s <30
years
12
Caplan et
al 1990
Case
series
cephalitis
with spinal
meningitis
TBM with
paraparesis
enhancement
Paraplegia
CSF cells 487µl,
CSF protein
4120mg/dl
Myelography, Intradural
collection with arterial and
venous thrombosis and cord
infarction
Infection,
intradural
collection
ATT and
antifungal
with
decompressi
ve
laminectom
y
Not reported
Died
after
surgery
11 patients
had TBM
at or before
paraparesis
Not mentioned
CT myelography in 13
showed Complete block
(11/13) most commonly at
level of conus medullaris and
arachnoiditis, intradural
tuberculoma (4/8);
MRI spine with contrast 2/5
tuberculoma, 3/5
arachnoiditis, 1/5
myelitis/vasculitis
Chronic
adhesive
arachnoiditis,
tuberculoma,
myelitis/vascul
itis
17M
TBM
Gradual quadriparesis
CSF protein 260
mg%
Biopsy; Chronic adhesive
arachnoiditis and
syringomyelia and cervicothoracic cord atrophy
Arachnoiditis,
syrinx, cord
atrophy
Not known
Died
36F
Not known
Gradual quadriparesis
Not known
Myelography; Adhesive
arachnoiditis and
syringomyelia
Arachnoiditis,
syrinx
Catheter
drainage
from syrinx
Not
improved
40F
TBM
Paraparesis
CSF protein 90
mg/dl, CSF cells
3024 mm3
Myelography and MRI spine;
Conus medullaris
arachnoiditis and
syringomyelia (T8 to T11)
Arachnoiditis,
syrinx
ATT,
steroid,
catheter
drainage of
Not
reported
Improved
5
syrinx
26F
58M
Pyogenic
meningitis
Gradual quadriparesis
(upper limb> lower limb)
CSF cells 4/ mm3
Not known
Gradual quadriparesis
(upper limb> lower limb)
CT myelography;
Syringobulbia and
syringomyelia in cervical cod
syrinx
Myelography
Syringomyelia
Myelography and MRI;
arachnoiditis ossificans and
arachnoid cyst with small
intramedullary cavitation
Arachnoiditis,
syrinx
Not known
Not
known
13
Van
Paesschen
et al 1990
Case
report
34F
TBM 20
year back
Spastic
Paraparesis
CSF cells 5
WBC/mm3,
protein 22 mg/dL,
glucose 77 mg/dL.
Normal CSF at
time of paraparesis
14
Schon
and
Bowler
1990
Naidoo et
al 1991
Case
report
40
TBM (2
year back)
Flaccid weakness in upper
limbs and dissociative
sensory loss
CSF protein 460
mg/dl; cells
5960/ml
MRI spine
Syringomyelia
Case
reports
14F
TBM with
LMN
weakness
of lower
limbs
Weakness paradoxically
progressed
The protein content
was 38 g/l
The post-myelogram CT scan
showed filling defects in the
thecal sac
Arachnoiditis
ATT and
corticosteroi
ds
improved
marginall
y
36 F
TBM with
LMN
involvemen
t of lower
limbs
Weakness paradoxically
progressed
Myelography at this
stage revealed a partial block
in the lower
thoracic and upper lumbar
region with diffuse
arachnoiditis
Arachnoiditis
ATT and
corticosteroi
ds and
surgical
decompressi
on
improved
marginall
y
15
Not known
ATT and
steroid at
time of
TBM
diagnosis(20
year back)
and
laminectom
y with
decompressi
on
ATT and
steroid
Not
known
Not
improved
Not
mentione
d
6
16
Fehlings
and
Bernstein
1992
Case
report
23M
TBM
Rapid progressive
weakness and numbness in
both hands (5 weeks later
to diagnosis of TBM)
CSF cells
11.7×106/L (95%
neutrophils; CSF
protein 2.3 g/l
MRI (enhancing extradural
lesion compressing the cord
from C6-D7),
Syringomyelia (C7-D8) on
repeat MRI
Arachnoiditis,
syrinx
17
Kumar et
al 1993
Case
report
23M
TBM
Rapid progressive
weakness (bilateral hand
weakness and sensory loss
below C8/T1 level
CSF protein 5.7 g/l
CSF cells 21/µl
Myelography showed nodular
thickening of lumbar roots;
MRI showed enhancing tissue
overlying the posterior aspect
of cervical and thoracic cord
Arachnoiditis
18
Lin et al,
1994
Case
report
36/M
2 months, Paraparesis,
urinary incontinence
Marked rise in
proteins and cells
Intramedullary tuberculoma,
arachnoiditis
19
Citow
and
Ammirati
, 1994
Case
report
31/M
TBM with
miliary
tuberculosi
s
TBM with
miliary
tuberculosi
s
2 weeks, Paraplegia
None mentioned
Intramedullary spinal
tuberculoma
20
Tacconi
et al 1995
Case
report
37/M
TBM
6 weeks, Paraparesis,
paraesthesia and urinary
problem
Increase in cells
but protein and
sugar improved
Intraspinal cord abscesses
21
Cruicksh
ank and
Johnston
1996
Dehoux et
al 1996
Case
report
19/F
TBM
3 months, Acute difficulty
in walking and right leg
paraesthesia
Not mentioned
Intradural, extramedullary
spinal tuberculous granuloma
Case
report
58M
TBM
Backache and paraparesis
CSF cells
305/mm3, CSF
protein 1500mg/L
MRI spine; Tuberculoma at
conus of spinal cord
22
Intramedullary
tuberculoma
ATT and
steroids,
Laminectom
y with
histopatholo
gy (AFB
positive);
syringoperitoneal
shunt on
repeat MRI
ATT
Not
improved
ATT,
corticosteroi
ds, spinal
surgery
ATT,
dexamethas
one,
removal of
the
tuberculoma
ATT,
dexamethas
one, spine
surgery
ATT, spine
surgery
Improved
ATT and
steroid
Partially
improved
Not
mentione
d
Improved
Slightly
improved
Improved
7
23
Hanci M
et al 1996
Case
report
7M
TBM with
paraparesis
Simultaneously,
suboccipital headache,
progressive paraparesis and
hypesthesia below T10
paraparesis
Not reported
MRI spine; Intramedullary
abscess at T7
Intramedullary
abscess
ATT,
surgery
Improved
24
Cheng et
al 1997
Case
report
23F
TBM
fluid smear
showed acid-fast
bacilli and bacterial
culture grew
Mycobacterium
tuberculosis
CSF protein 0.14
g/l, cells 336 x
106/l, sugar 1.3
mmol/l
CSF protein 115
mg/dL Tuberculous
bacilli in sputum
was drug resistant
MRI spine; Intramedullary
spinal cord abscess
Intramedullary
abscess
no
neurologi
cal
recovery
MRI spine; Intramedullary
tuberculoma in thoracic cord
Tuberculoma
ATT an
dexamethas
one ,
Thoracic
laminectom
y
Not known
25
Garg and
Karak
1998
Case
report
30M
TBM
Paraparesis with bladder
involvement
26
Borges et
al 1998
Case
report
TBM with
miliary
tuberculosi
s
Cervical
myeloradiculopathy and
neck pain
27
OÈzates
et al 2000
Case
report
26/M
HIV
positiv
e and
multidr
ugresista
nt
dissem
inated
tuberc
ulosis
45M
MRI spine; an intramedullary
nodular lesion at the level of
C4,
Tuberculoma
6 drug ATT,
ART and
corticosteroi
ds
Improved
TBM with
miliary
tuberculosi
s
1 year of irregular ATT,
Spastic paraparesis and
incontinence
Not mentioned
a spinal subdural abscess at
T3-T4 level
Abscess
Improved
TBM (6
year back)
Spastic paraparesis
Not mentioned
MRI; Extensive arachnoiditis
and multiloculated syrinx in
thoracic cord
Arachnoiditis,
syrinx
TBM
3 and half months,
areflexic paraparesis
No significant
change
thickening meninges
surrounding the cervical,
Arachnoiditis,
syrinx
ATT,
dexamethas
one, shunt
and later
spinal
surgery
ATT and
decompressi
ve surgery
28for syrinx
ATT,
Methylpredn
28
Kaynar et
al 2000
Case
report
30F
29
Herna´nd
ez-Albu´
Case
report
27M
HIV-
Not
known
Partially
improved
Not
improved
8
positiv
e
jar et al
2000
thoracic, and lumbar spinal
cord; enhancement of the
cervical and thoracic
meninges, loculations, and
obliteration of the
subarachnoid space and
meningeal tuberculomas,
Syringomyelia after 4 months
isolone
30
Hui et al
2001
Case
report
21 F
TBM
6 months, Flaccid
paraparesis
Not mentioned
Arachnoiditis with
extramedullary tuberculoma;
1 year syrinx
Arachnoiditis,
tuberculoma,
syrinx
31
Kemaloğl
u et al
2001
Case
report
32 M
TBM and
pulmonary
tuberculosi
s
Increase in CSF
proteins and cells
conus medullaris tuberculoma
Tuberculoma
32
Kobayash
i et al
2002
Case
report
54F
TBM
Protein= 150 mg/dl
cell count= 1
(lymphocyte)
Sumner
et al 2003
Case
report
31M
HIV
positiv
e
TBM
interrupted contrast flow at
the level of T-4
syringomyelia in thoracic
spinal cord
1-cm enhancing, intradural,
extramedullary mass at left T4
Arachnoiditis,
tuberculoma
33
6 months, urinary
incontinence, lower limb
pain and progressive
weakness in legs and
impotence
30 years, persistent
weakness of the left leg
and progressive gait
disturbance
4 weeks, Recurrent
myelopathy
34
Moghtade
ri and
Naini
2003
Case
report
21F
TBM
Paraparesis
Myelography; Conus and
cauda arachnoiditis,
Intramedullary tuberculoma
Archnoidiis,
tuberculoma
35
Tanriver
di et al
2003
Case
report
7M
TBM with
intramedull
ary
abscess
Paraparesis and bladder (1
month)
CSF cells 2600
leukocytes/µl,
protein 240mg/dL,
glucose level
40mg/dL
Not mentioned
MRI; D7 intramedullary
cystic ring enhancing mass
Tuberculoma
protein 153 mg/dL
Cells: 73 white
blood
cells/mm3 (81%
lymphocytes)
Tuberculoma
ATT,
dexamethas
one, shunt
surgery
ATT,
dexamethas
one, spinal
surgery
Partially
improved
spinal
surgery
a calcified
mass at C6
ATT,
HAART and
spinal
surgery
initially later
dexamethas
one
ATT
Improved
ATT,
laminectom
y with
aspiration of
Improved
Improved
Improved
Not
known
9
30M
with
pulmonary
TB
TBM (9
year ago)
Paraparesis(2 year)
Not mentioned
MRI; Extensive arachnoiditis,
Multiloculated syrinx
Arachnoiditis,
syrinx
MRI; Homogeneous
enhancing
intradural mass
at T3–L2
Follow-up at 14 month,
Arachnoiditis and
syrinx at T3–10
An extramedullary mass of
the spinal cord, extending
from D2 to whole of the
dorsal section
extensive subdural
collection over the thoracic
spine region with cord
compression
cystic arachnoiditis; thoracic
subarachnoid space was
loculated; clumping of nerve
roots and anterior loculations
of the CSF
spinal intradural arachnoid
cyst at C1 to C3 with
extensive myelomalacia
Arachnoiditis,
syrinx, abscess
21M
TBM (2
year ago)
Paraparesis with loss of
bladder/bowel control(1
week)
Not mentioned
36
Skendros
et al, 2003
Case
report
27/M
TBM
3 months, Transverse
medullary syndrome at the
D4 spinal cord level
Markedly increased
protein level (4,500
mg/dl)
37
Poon et al
2003
Case
report
36F
TBM
6 days, Acute compressive
myelopathy
Markedly increased
protein level (10
g/d)
38
Srivastav
a and
Kochar
2003
Case
series of
16
patients
Not
mentio
ned
TBM
Simultaneous, 3 had
asymptomatic spinal
arachnoiditis
Not mentioned
39
Lolge et
al 2004
Case
reports
35F
TBM,
pulmonary
TB and
spinal
tuberculosi
s T11-12
3 year 6months,
Spastic quadriparesis
TBM
2 year, Spastic paraparesis
58M
Abscess
Abscess
Arachnoiditis
Arachnoiditis
pus (AFB
positive)
ATT
Laminectom
y and
syringesubarachnoi
dostomy
(twice)
Hemilamine
ctomy+
biopsy
Partially
improved
after 2nd
surgery
Partially
improved
ATT,
dexamethas
one, surgical
removal
ATT,
dexamethas
one, surgical
removal
Not
mentioned
Good
recovery
Surgery
Not
improved
Good
recovery
Not
mentione
d
Arachnoiditis
spinal intradural arachnoid
cyst at D4 to D7
surgery
Improved
10
Shaharao
et al, 2004
Chotmon
gkol et al
2005
Case
report
Case
report
6/F
TBM
17M
TBM
42
Blaivas et
al, 2005
Case
report
22/M
43
Roca
2005
Review of
22 cases
44
Muthuku
mar et al,
2007
Muthuku
mar and
Sureshku
mar 2007
Moghtade
ri et al,
2007
Katchano
v et al
40
41
45
46
47
6 months, Thoracic
myelopathy
Quadriparesis with bladder
involvement
Not specified
Intra-medullary tuberculoma
Tuberculoma
CSF protein 369
mg/dl
Arachnoiditis,
myelitis
TBM
1 month, Tuberculous
radiculomyelits
None reported
MRI; Thoracic cord
enhancement at D7 level
Repeat MRI later, CSF
loculations at upper cervical
level, myelitis
Tuberculoma
27
year
(media
n age)
TBM in 17
cases
TBM with
Intradural
extramedul
lary
tuberculom
a of the
spinal cord
simultaneo
usly in 4
patients
Paraparesis
in all 22 cases (100%),
hypoesthesia with a
sensory level in 20 patients
(91%), and urinary
sphincter dysfunction in 14
patients (64%).
Variable protein
and cells
MRI in 13 and myelography
in 9; Intradural extramedullary
tuberculoma of the spinal cord
in all and syringomyelia in 1
Tuberculoma,
syrinx
Case
report
21/M
TBM
6 months, Myelopathy
(paraparesis)
None reported
Intradural extramedullary
granuloma
Tuberculoma
ATT,
surgery
Case
report
27F
TBM
Spastic paraparesis with
incontinence
Not reported
Tuberculoma,
syrinx
Case
report
21/F
TBM
1 month, Paraparesis and
vision loss
Not changed
MRI spine; Intraduralextramedullary tuberculoma at
lower thoracic level with
extensive syrinx
Spinal arachnoiditis
Case
reports
69F
TBM (TBPCR and
Not mentioned
CSF protein 432
mg/dl, cells 230/µl
MRI spine; Syringomyelia in
thoracic cord
Syrinx
ATT,
steroid,
decompressi
ve surgery
ATT,
ventriculoperitoneal
shunt, spinal
surgery
ATT and
steroid
Arachnoiditis
ATT,
prednisolone
ATT,
steroid,
cervical
laminectom
y
ATT,
corticosteroi
ds
ATT,
corticosteroi
d, surgery
variably
Complete
recovery
Died
Improved
All
patients
improved
;
17 (77%)
remained
with
variable
degrees
of
persistent
walking
difficulty.
Improved
Partially
improved
Improved
Not
mentione
11
culture
positive)
TBM
Not mentioned
Not mentioned
MRI spine
Arachnoiditis
Not
mentioned
8mont
hs/M
TBM
progressive quadriplegia
Not mentioned
MRI spine; intramedullary
ring-enhancing lesion
Tuberculoma
ATT,
ventriculoperitoneal
shunt
3/M
TBM
weakness of
the left leg
Not mentioned
MRI spine; arachnoiditis with
extradural tuberculous abscess
Arachnoiditis,
abscess
Not
mentioned
Not
mentione
d
20M
TBM
4th day, paraplegia
developed with asymmetric
sensory loss and
incontinence, DTRs were
absent and plantar extensor
Protein 59.8 g/l at
8
Weeks
MRI spine revealed an
obliterated subarachnoidal
space in the thoracic and
lumbar segments and
enhancement of the
meninges,
Hyperintense signal T4-T9 of
the thoracic spinal cord
extensive
arachnoiditis ,
myelitis
ATT and
corticosteroi
ds
Improved
44M
TBM
6 months later, spastic
paraparesis
CSF 8 cells/ml and
43.1 g/l protein
Multiple
tuberculoma
ATT and
corticosteroi
ds (both iv
and
intrthecal)
ATT, spinal
surgery
Improved
ATT, spinal
surgery
Not
improved
2007
48
49
du Plessis
et al 2008
Hristea et
al 2008
Case
reports
Case
reports
6mont
hs/M
d
50
Ozek et
al, 2009
Case
report
18/F
TBM
6 months, Spastic
paraparesis
None reported
51
Calaf et
al, 2009
Case
report
28/M
TBM with
multiple
tuberculom
a
1 ½ months, Paraplegia
None reported
multiple intramedullary
lesions at D4, D5—6, D8,
D10, and D11
An intradural extramedullary
en plaque-shaped tuberculoma
extending from D1-9 vertebral
column
Intradural-extramedullary
tuberculoma
Tuberculoma
Tuberculoma
Not
mentione
d
Not
mentione
d
Marked
improved
12
52
Chitre et
al, 2009
Case
report
6/F
TBM
5 months, spastic
paraparesis
53
Shim et
al, 2010
Case
report
24/M
1 month, Thoracic
myelopathy
54
Gul et al,
2010
Case
report
21/M
TBM,
pulmonary
tuberculosi
s
TBM
3 months, Thoracic
myelopathy
None reported
55
Choi et
al, 2011
Case
report
31/M
TBM
12 months, Progressive
quadriparesis
None reported
56
Malhotra
et al, 2012
Case
report
32/F
TBM
None reported
57
Sundara
m et al
2012
Das et al,
2012
Case
report
37/M
(HIV+
)
35/M,
TBM
4 months, Progressive,
areflexic, sensorimotor
paraparesis with bowel &
bladder involvement.
6 years, spastic weakness
of the right leg
1 month, weakness of both
lower limbs, retention of
urine, involuntary
movements
Not reported
58
Case
report
TBM
CSF 200 lymphocytes/mL, sugar
42.8 mg/dL,
proteins 29.7
mg/dL
None reported
None reported
Intramedullary (T9-10) and
intracranial tuberculomas
Tuberculoma
ATT,
surgery
Improved
Intradural, extramedullary
tuberculoma &lumbosacral
tuberculosis spondylitis with
multiple abscesses
intradural-extramedullary
tuberculoma, later
syringomyelia
Intradural
tuberculoma,
pott’s spine,
abscess
Intradural
Tuberculoma,
syrinx
ATT, spinal
surgery
Improved
ATT,
prednisolone
Multiple intradural
extramedullary nodular
masses at
cervical & dorsal spinal cord;
at 3 years
syringomyelia & multiple
intradural extramedullary
tuberculoma
Thoraco-lumbar arachnoiditis
Intradural
tuberculoma,
syrinx
ATT,
dexamethas
one,
laminectom
y & excision
of the mass
Improved
with
syringoperitoneal
shunt
Not much
improve
ment
Arachnoiditis
ATT,
dexamethas
one
None
reported
multiloculated syrinx in the
thoracic spinal cord extending
from the T2 to the T11 level
Multiple inflammatory
granulomas, lacunar infarct in
pons, spinal cord compression
with edema at D3-D4 level;
multiple ring-enhancing
lesions in both cerebral
hemispheres
Syrinx
ATT (6
years back)
None
reported
Arachnoiditis,
cord
compression,
ATT,
prednisolone
Improved
with
residual
parapares
is
13
59
Agarwal
et al, 2012
Case
report
35/M
TBM
6 months, Spastic
paraplegia
Not reported
60
Saini et al
2012
Case
report
4/M
TBM with
hydrocepha
lus
At time of diagnosis of
TBM, quadriparesis and
bladder involvement
Not reported
61
Tekin et
al, 2013
Case
report
36/M
6 months, paraparesis
Not reported
62
Pandey et
al, 2013
Case
report
26 F
TBM with
pulmonary
tuberculosi
s
TBM
6 weeks, Flaccid
quadriparesis
Not reported
63
Lawler et
al, 2013
Case
report
12F
(HIV+
)
A
tuberculous
cerebellar
abscess
64
Smith et
al 2013
Ranganat
han and
Hogarth,
2013
Case
report
Case
report
45M
TBM
22/M
disseminate
d
tuberculosi
s with
TBM
1 year after starting
HAAR,T paraparesis and
sphincter
dysfunction after
improvement in her CD4
count, following
antiretroviral therapy
Simultaneous, urinary
retention
1 month, sudden weakness
in all four limbs
Sahu et
al, 2014
Case
report
22M
TBM
5 months paradoxical,
subacute onset
sensorimotor paraparesis
65
66
Extramedullary dorsal
tuberculoma (enplaque type)
extending from D1- D12
level)
Cervical intramedullary
conglomerate tuberculomas
Extramedullary
tuberculoma
ATT, spinal
surgery
Improved
Intramedullary
tuberculoma
improved
Intracranial and
intramedullary tuberculoma
with vertebral
abscess
long syrinx from C6 to T3
level
Tuberculoma,
POTT’S spine
ATT,
steroid,
ventroperitoneal
shunt
ATT
Partial
improve
ment
Protein=5.95 g/dl,
glucose =2.0 g/dl
and 38
lymphocytes/mm3
Intramedullary conus
medullaris tuberculoma
Tuberculoma
ATT,
dexamethas
one, shunt
surgery
ATT and
HAART and
later on
corticosteroi
ds
Protein
1.44 g/l
protein 0.9 g/L
Enhancement
over the lower thoracic cord
MRI of the upper cervical
spine, showing the enhancing
loculated collections
surrounding the spinal cord
and the brainstem.
Arachnoiditis
ATT
Improved
Loculated
collection
Improved
Not reported
ring enhancing intramedullary
tuberculoma at D4 level
Tuberculoma
ATT,
dexamethas
one, shunt
surgery with
decompressi
on of the
craniocervic
al junction
ATT,
dexamethas
one
Syrinx
Improved
Improved
Not
reported
14
67
Das et al,
2014
Case
report
17M
TBM
68
Fujimori
and
Nakashim
a, 2014
Sahu et
al, 2014
Case
report
38M
TBM
Case
series
35/
transge
nder
(HIV+
)
69
with urinary urgency
6 months paradoxical,
spastic quadriparesis
Not reported
intramedullary tuberculoma at
C3-6 level, cerebellar
tuberculoma
Tuberculoma
ATT,
dexamethas
one, shunt
surgery and
spinal
surgery
Not reported
Improved
2 years, progressive gait
disturbance progressed
over 6 years
Not reported
syringomyelia extending from
T3 to the conus medullaris
Syrinx
TBM?
Presenting illness,
sudden-onset lower motor
neurone paraplegia and
urinary retention
Protein raised
(PCR positive for
Mycobacterium
tuberculosis)
Diffuse long segment spinal
cord signal alteration
extending from C7 to the
conus. MRI of the brain
showed multiple small ringenhancing lesions.
Myelitis
ATT and
ARV
gradually
improved
over 8
weeks
40/F
Miliary TB
and TBM?
Presenting illness,
acute-onset rapidly
progressive weakness of
lower limbs and retention
of urine
PCR positive for
Mycobacterium
tuberculosis)
Diffuse long segment spinal
cord signal alteration
extending from D1 to the
conus. MRI of the brain
showed multiple small ringenhancing lesions.
Myelitis
ATT
gradually
improved
over 6
weeks
40/M
TBM
Presenting illness,
acute-onset rapidly
progressive weakness of
lower limbs and retention
20 cells/ml (50%
lymphocytes),
protein 200 mg/l
signal intensity involving the
dorsal cord from D6 to D10
levels
Myelitis
ATT with
Methyl
prednisolone
improved
gradually
over 10
weeks
Not
reported
15
of urine
45/M
70
2/M
Presenting illness,
Acute quadriparesis
40 cells/ml in the
CSF, protein was
440 mg/dl
ill-defined T2 hyperintensities
in the dorsal cord from D2 to
D9 levels
Myelitis
ATT with
Methyl
prednisolone
improved
gradually
over 12
weeks
Improved
with
resolution
of syrinx
TBM with
6 years, quadriparesis and
Not reported
cervicodorsal expanding
Syrinx
fresh
multiple
truncal ataxia
syrinx and dilated 4th
ventriculopl
episodes of
ventricle
eural shunt
2014
shunt
malfunctio
n
ATT: Anti-tuberculosis treatment, CSF: Cerebrospinal fluid, D: Dorsal, F: Female, ICP: Intracranial pressure, M: Male, MPS: Methylprednisolone, PR: Paradoxical reaction, TBM:
Tuberculous meningitis; CNS: central nervous system; CT: computed tomography; MRI: magnetic resonance imaging; IETSC: intradural extramedullary tuberculoma in spinal cord
Aniruddha
and
Nupur,
Case
report
TBM
16
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