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Syringomyelia Developing as an Acute Complication of Tuberculous Meningitis

Published online by Cambridge University Press:  18 September 2015

Abdu Kader Daif ,
Al Rajeh ,
Adesola Ogunniy ,
Amer Al Boukai  and
Abdulrahman Al Tahan
Abdu Kader Daif*
Affiliation:
Division of Neurology and Radiology (A.A.B.), College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Al Rajeh
Affiliation:
Division of Neurology and Radiology (A.A.B.), College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Adesola Ogunniy
Affiliation:
Division of Neurology and Radiology (A.A.B.), College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Amer Al Boukai
Affiliation:
Division of Neurology and Radiology (A.A.B.), College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Abdulrahman Al Tahan
Affiliation:
Division of Neurology and Radiology (A.A.B.), College of Medicine, King Saud University, Riyadh, Saudi Arabia.
*
King Khalid University Hospita, P.O. Box 7805 (38), Riyadh 11472 Saudi Arabia.
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Abstract:

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Background:

Tuberculosis of the nervous system has protean manifestations. Syringomyelia, though an uncommon complication of it, is usually of late onset.

Methods:

We report two patients with tuberculosis meningitis who developed syringomyelia acutely. The diagnosis was supported by neuroimaging and findings at laminectomy.

Results:

The two patients developed syringomyelia between 11 days and 6 weeks of the onset of tuberculous meningitis. They both had cord swelling and softening

Conclusions:

Acute-onset syringomyelia should be suspected in any patient being treated for tuberculosis meningitis who subsequently develops limb weakness and/or sphincteric dysfunction. Inflammatory edema and cord ischemia appeared to be the underlying mechanisms in these early onset cases rather than arachnoiditis which is important in late-onset cases.

Résumé:

RÉSUMÉ:Introduction:

La tuberculose du système nerveux a des manifestations variées. La syringomyélic, bien qu'elle en soit une complication rare, est habituellement tardive.

Méthodes:

Nous rapportons les cas de deux patients, atteints de méningite tuberculeuse, qui ont présenté une syringomyélic aiguë. Le diagnostic a été étayé par l'imagerie et les constatations faites au moment de la laminectomie

Résultats:

Les deux patients ont développé une syringomyélic entre 11 jours et 6 semaines du début de leur maladie diagnostiquée comme une méningite tuberculeuse. Ils avaient tous deux des manifestations d'oedème et de ramollissement de la moelle.

Conclusion:

La syringomyelic d'installation aiguë devrait être soupçonnée chez tous les patients qui sont traités pour une méningite tuberculeuse et qui développent subséquemment de la faiblesse des membres et/ou une dysfonction sphinctérienne. L'oedème inflammatoire et l'ischémie de la moelle semblaient être les mécanismes sous-jacents chez ces cas à début précoce plutôt qu'une arachnoїdite qui est une entité importante chez les cas tardifs.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 24 , Issue 1 , February 1997 , pp. 73 - 76
Copyright
Copyright © Canadian Neurological Sciences Federation 1997

References

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