Open AccessConcurrent cerebellar and cervical intramedullary tuberculoma: Paradoxical response on antitubercular chemotherapy and need for surgery
Author(s) -
Kuntal Kanti Das,
Sushila Jaiswal,
Mukesh Shukla,
Arun Kumar Srivastava,
Sanjay Behari,
Raj Kumar
Publication year - 2014
Publication title -
journal of pediatric neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.247
H-Index - 18
eISSN - 1998-3948
pISSN - 1817-1745
DOI - 10.4103/1817-1745.139336
Subject(s) - tuberculoma , medicine , lesion , intramedullary rod , tuberculosis , surgery , cerebellar hemisphere , paradoxical reaction , cerebellum , pathology
Spinal intramedullary tuberculoma (SIT) is a rare manifestation of neurotuberculosis. Concurrent SIT and intracranial tuberculoma are further unusual. Most of these tuberculomas respond completely to medical therapy, and surgical excision is seldom required. In this report, we describe a 17-year-old boy who developed cervical intramedullary tuberculoma at C3-C6 level with a concurrent lesion involving the right cerebellar hemisphere while on treatment for tubercular meningitis. This patient had paradoxical increase in size of the cervical lesion even though the cerebellar lesion showed regression in size. In this article, we discuss the paradoxical response to anti-tubercular therapy in central nervous system tuberculosis, possible causes of nonresolution of tuberculoma on medical therapy and evaluate the role of surgery in these cases.