Spinal cord tuberculoma
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Cough for 1 month, Weakness and numbness of bilateral lower limbs for 10 days and urinary retention for 2 days
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At the lower end of the cord, at the level of T12, there is a 1.4 x 1.6 cm T1 isointense and T2 hypointense spinal cord lesion. Perilesional edema surrounds the lesion. Peripheral smooth ring enhancement is visible after contrast administration.
This patient also had respiratory symptoms, and two AFB sputum smears were positive for acid-fast bacilli. Considering these lab values and MRI findings (centrally T2 hypointense lesion with peripheral edema and rim enhancement on post-contrast), findings are in line with caseous stage of tuberculoma.
Spinal cord tuberculoma is a very rare presentation of CNS tuberculosis and the aforementioned case shows spinal intramedullary tuberculoma.
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