Purpose or Case Report: Tubercular infection of spine occurs in the form of tuberculous spondylitis, intradural tuberculosis, and tubercular myelitis in the decreasing frequency. Intradural tuberculosis has been variously termed as intradural extramedullary tuberculosis, spinal arachnoididtis and chronic adhesive arachnoiditis. Spinal TB radiculomyelitis is a secondary TB lesion, although it may rarely occur primarily. This is a casereport of 18 year old male child who is a known case of TB meningitis and developed syringomyelia and arachnoiditis.
Methods & Materials: An 18 year old male who is a known case of TB meningitis on treatment for 6 months now presented with progressive quadriparesis of 2 months duration. No history of trauma or any viral infection. Childhood was uneventful. On examination, higher mental functions were normal. In view of the history MRI was done and revealed following findings.
Results: Sagittal MRI images showed a long segment T1 hypointense, T2 hyperintense lesion involving cervical cord upto C4 vertebral body suggestive of syrinx. There was associated hydrocephalus. On contrast administration, there was enhancement involving the meningeal layers of dorsal spinal cord.
Conclusions: CNS tuberculosis represents approximately 10% of extra pulmonary tuberculosis. However, spinal tuberculous arachnoiditis is a rare complication of CNS tuberculosis, that can result in severe peripheral neurological deficit. Thoracic spinal cord is most frequently involved site, followed by lumbar and cervical spinal cord. Atypical forms of tuberculosis should be designated as tuberculous radiculomyelopathy.