Advertisement

Child's Nervous System

, Volume 24, Issue 4, pp 453–457 | Cite as

Unusual forms of spinal tuberculosis

  • Jaco du PlessisEmail author
  • Savvas Andronikou
  • Salomine Theron
  • Nicky Wieselthaler
  • Murray Hayes
Original Paper

Abstract

Objective

The incidence of tuberculosis (TB) is increasing in both developing and developed worlds, and children, in particular, represent a high-risk group for acquiring the disease. TB of the central nervous system is the most severe, life-threatening form of TB in infants and children. Approximately 10% of all patients with TB have central nervous system involvement.

Materials and methods

We have selected four pediatric cases of unusual spinal TB that presented to our institution during the last 5 years. These include TB arachnoiditis, intramedullary spinal cord tuberculoma, TB spondylitis of the odontoid peg, and one child with tuberculous extradural abscess.

Conclusion

TB may involve the intramedullary, extramedullary intrathecal compartment, or the extrathecal vertebral compartment in the form of an arachnoiditis, abscess, and spondylitis, respectively, often with unusual imaging presentations.

Keywords

Spinal tuberculosis Arachnoiditis Spondylitis Intramedullary Tuberculoma Extradural abscess 

References

  1. 1.
    Loke TK, Ma HT, Chan CS (1997) Magnetic resonance imaging of tuberculous spinal infection. Australas Radiol 41(1):7–12PubMedGoogle Scholar
  2. 2.
    Agrons GA, Markowitz RI, Kramer SS (1993) Pulmonary tuberculosis in children. Semin Roentgenol 28(2):158–172PubMedCrossRefGoogle Scholar
  3. 3.
    Jamieson DH (1995) Imaging intracranial tuberculosis in childhood. Pediatr Radiol 25(3):165–170PubMedCrossRefGoogle Scholar
  4. 4.
    Waecker NJ, Connor JD (1990) Central nervous system tuberculosis in children: a review of 30 cases. Pediatr Infect Dis J 9(8):539–543PubMedCrossRefGoogle Scholar
  5. 5.
    Doerr CA, Starke JR, Ong LT (1995) Clinical and public health aspects of tuberculous meningitis in children. J Pediatr 127(1):27–33PubMedCrossRefGoogle Scholar
  6. 6.
    Witrak BJ, Ellis GT (1985) Intracranial tuberculosis: manifestations on computerized tomography. South Med J 78(4):386–392PubMedGoogle Scholar
  7. 7.
    Wood M, Anderson M (1998) Chronic Meningitis. Neurological infections, major problems in neurology, Vol 16. Philadelphia, WB Saunders, pp 169–248Google Scholar
  8. 8.
    Bernaerts A, Vanhoenacker FM, Parizel PM et al (2003) Tuberculosis of the central nervous system: overview of neuroradiological findings. Eur Radiol 13(8):1876–1890PubMedCrossRefGoogle Scholar
  9. 9.
    Garg RK (1999) Tuberculosis of the central nervous system. Postgrad Med J 75(881):133–140PubMedGoogle Scholar
  10. 10.
    Reichman LB (1997) Tuberculosis elimination—what’s to stop us? Int J Tuberc Lung Dis 1(1):3–11PubMedGoogle Scholar
  11. 11.
    Pande KC, Babhulkar SS (2002) Atypical spinal tuberculosis. Clin Orthop Relat Res 398:67–74PubMedCrossRefGoogle Scholar
  12. 12.
    Yalniz E, Pekindil G, Aktas S (2000) Atypical tuberculosis of the spine. Yonsei Med J 41(5):657–661PubMedGoogle Scholar
  13. 13.
    Moghtaderi A, Alavi Naini R (2003) Tuberculous radiculomyelitis: review and presentation of five patients. Int J Tuberc Lung Dis 7(12):1186–1190PubMedGoogle Scholar
  14. 14.
    Sharma A, Goyal M, Mishra NK et al (1997) MR imaging of tubercular spinal arachnoiditis. Am J Roentgenol 168(3):807–812Google Scholar
  15. 15.
    Poon TL, Ho WS, Pang KY, Wong CK (2003) Tuberculous meningititis with spinal tuberculous arachnoiditis. Hong Kong Med J 9(1):59–61PubMedGoogle Scholar
  16. 16.
    Devi BI, Chandra S, Mongia S et al (2002) Spinal intramedullary tuberculoma and abscess: a rare cause of paraparesis. Neurol India 50(4):494–496PubMedGoogle Scholar
  17. 17.
    Dastur HM (1983) Diagnosis and neurosurgical treatment of tuberculous disease of the CNS. Neurosurg Rev 6(3):111–117PubMedCrossRefGoogle Scholar
  18. 18.
    MacDonnell AH, Baird RW, Bronze MS (1990) Intramedullary tuberculomas of the spinal cord: a case report and review. Rev Infect Dis 12(3):432–439PubMedGoogle Scholar
  19. 19.
    Bansal D, Singhi PD, Ray M et al (2002) Cervical intramedullary tuberculoma: acute presentation and rapid response to medical therapy. J Trop Pediatr 48(1):55–57PubMedCrossRefGoogle Scholar
  20. 20.
    Kayaoglu CR, Tuzun Y, Boga Z et al (2000) Intramedullary spinal tuberculoma: a case report. Spine 25(17):2265–2268PubMedCrossRefGoogle Scholar
  21. 21.
    Gupta RK, Jena A, Sharma A et al (1988) MR imaging of intracranial tuberculomas. J Comput Assist Tomogr 12(2):280–285PubMedCrossRefGoogle Scholar
  22. 22.
    Moon MS (1997) Tuberculosis of the spine. Controversies and a new challenge. Spine 22(15):1791–1797PubMedCrossRefGoogle Scholar
  23. 23.
    Tuli SM (1974) Tuberculosis of the craniovertebral region. Clin Orthop Relat Res 104:209–212PubMedCrossRefGoogle Scholar
  24. 24.
    Krishnan A, Patkar D, Patankar T et al (2001) Craniovertebral junction tuberculosis: a review of 29 cases. J Comput Assist Tomogr 25(2):171–176PubMedCrossRefGoogle Scholar
  25. 25.
    Kotevoglu N, Tasbasi I (2004) Diagnosing tuberculous spondylitis: patients with back pain referred to a rheumatology outpatient department. Rheumatol Int 24(1):9–13PubMedCrossRefGoogle Scholar
  26. 26.
    Lifeso RM, Weaver P, Harder EH (1985) Tuberculous spondylitis in adults. J Bone Jt Surg Am Vol 67(9):1405–1413Google Scholar
  27. 27.
    Almeida A (2005) Tuberculosis of the spine and spinal cord. Eur J Radiol 55(2):193–201PubMedCrossRefGoogle Scholar
  28. 28.
    Kim NH, Lee HM, Suh JS (1994) Magnetic resonance imaging for the diagnosis of tuberculous spondylitis. Spine 19(21):2451–2455PubMedCrossRefGoogle Scholar
  29. 29.
    Gupta RK, Agarwal P, Rastogi H et al (1996) Problems in distinguishing spinal tuberculosis from neoplasia on MRI. Neuroradiology 38(Suppl 1):S97–S104PubMedCrossRefGoogle Scholar
  30. 30.
    Reihsaus E, Waldbaur H, Seeling W (2000) Spinal epidural abscess: a meta-analysis of 915 patients. Neurosurg Rev 23(4):175–204PubMedCrossRefGoogle Scholar
  31. 31.
    Hlavin ML, Kaminski HJ, Ross JS, Ganz E (1990) Spinal epidural abscess: a ten-year perspective. Neurosurgery 27(2):177–184PubMedCrossRefGoogle Scholar
  32. 32.
    Teman AJ (1992) Spinal epidural abscess. Early detection with gadolinium magnetic resonance imaging. Arch Neurol 49(7):743–746PubMedGoogle Scholar
  33. 33.
    Jinkins JR, Gupta R, Chang KH, Rodriguez-Carbajal J (1995) MR imaging of central nervous system tuberculosis. Radiol Clin North Am 33(4):771–786PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Jaco du Plessis
    • 1
    Email author
  • Savvas Andronikou
    • 1
  • Salomine Theron
    • 1
  • Nicky Wieselthaler
    • 2
  • Murray Hayes
    • 1
  1. 1.Department of RadiologyTygerberg Hospital, University of StellenboschTygerbergSouth Africa
  2. 2.Department of Radiology, Red Cross War Memorial Children’s HospitalUniversity of Cape TownCape TownSouth Africa

Personalised recommendations