Beyin ve medüller spinal kord tüberkülomu birlikteliği: cerrahi tedaviye ihtiyaç duyulmayan bir olgu

Öz

Merkezi sinir sistem MSS tüberkülozu, tüberkülozun daha nadir rastlanan bir formudur. Genellikle yüzeyel infekte bir alanın rüptürü sonrasında yayılır. Bu yazıda 18 yaşında bir kadın hastada, çok ender görülen beyin ve medüller spinal kord tutulumunun birlikte görüldüğü MSS tüberkülozu olgusu sunulmaktadır. Hasta, cerrahi herhangi bir müdahaleye ihtiyaç duymadan antitüberküloz tedavi ile iyileşti. Türkiye gibi tüberküloz açısından endemik bölgelerde, ateş, gece terlemeleri, diplopi ve fokal nörolojik hasar varlığında MSS tüberkülozu akla getirilmelidir. Ayrıca MSS tüberkülozu olan hastaların hepsinde de cerrahi müdahaleye ihtiyaç duyulmayabilir

Anahtar Kelimeler

• Beyin,ekstrapulmoner tüberküloz,spinal tuberkülom

Concurrent intracranial and intramedullary spinal cord tuberculomas: a case who did not require surgical intervention

Öz

Central nervous system CNS tuberculosis is an unusual entity of tuberculosis. It usually results from rupture of superficial infective focus. Here, we report a rare case of concurrent intracranial and intramedullary spinal cord tuberculomas in an 18-year-old woman. The patient was presented with headache, diplopia, malaise, weight loss and intermittent fever. She improved well on antituberculous drugs without neurosurgical excision of the lesions. We emphasize that, in endemic areas of tuberculosis, such as Turkey, in the presence of fever, night sweats, diplopia and focal neurological deficits, one should not rule out the existence of CNS tuberculosis. Also not all cases of CNS require surgical intervention

Anahtar Kelimeler

• Brain,extrapulmonary tuberculosis,spinal tuberculoma

Kaynakça

1. Global tuberculosis control epidemiology, strategy, f i n a n c i n g W H O R e p o r t 2 0 0 9 http://www.who.int/tb/publications/global_report/2009/ en/index.html
2. Bennett JE. Chronic meningitidis. In: Mandell GL, Bennett JE, Dolin R (eds). Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Churchill Livingstone. 2010. pp. 1237-42.
3. Shenoy SN, Raja A. Concurrent intramedullary and intracranial tuberculomas. Neurol India 2004; 52: 514-6.
4. Li H, You C, Yang Y, He M, Cai B, Wang X, Ju Y. Intramedullary spinal tuberculoma: report of three cases. Surg Neurol 2006; 65: 185-9.
5. Garcia-Monco JC. Central nervous system tuberculosis. In: Marra CM, editors. Neurologic clinics – central nervous system infections. Philadelphia: WB Saunders Company, 1999; 17: 737–58.
6. TC Ministery of Health. Expanded Program on Immunization, 2008. (In Turkish).
7. Kati MK. Pathogenesis, diagnosis, treatment, and.outcome aspects of cerebral tuberculosis. Med Sci Monit 2004; 10: 215-9.
8. Thomson RB Jr, Bertram H. Laboratory diagnosis of central nervous system infections. Infect Dis Clin North Am ; 15: 1047-71.

9. World Health Organization Tuberculosis unit, Division of Communicable Diseases: Guidelines for tuberculosis treatment in adults and children in national treatment programmes. WHO Geneva, 1991: WHO/Tb/ 91: 1–61.
10. Harran Üniversitesi Tıp Fakültesi Dergisi (Journal of Harran University Medical Faculty) Cilt 9. Sayı 2, 2012