Hostname: page-component-848d4c4894-pftt2 Total loading time: 0 Render date: 2024-06-03T23:54:11.409Z Has data issue: false hasContentIssue false
  • English
  • Français

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.
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
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

REFERENCES

1. Frieden, TR, Fujiwara, PI, Washko, RM, Hamburg, MA Tuberculosis in New York City – turning the tide. N Engl J Med 1995; 333: 229–233.Google Scholar
2. Daif, AK, Obeid, T, Yaqub, B, Abdul Jabbar, M Unusual presentation of tuberculous meningitis. Clin Neurol Neurosurg 1992; 94: 1–5.Google Scholar
3. Kent, SJ, Growe, SM, Yung, A, Lucas, CR, Mijeh, FM Tuberculous meningitis: a 30-year review. Clin Infect Dis 1993; 17: 987–994.Google Scholar
4. Kennedy, DH, Fallon, RJ Tuberculous meningitis. JAMA 1979; 241: 264–268.CrossRefGoogle ScholarPubMed
5. Caplan, LR, Norhna, AB, Amico, LL Syringomyelia and arachnoiditis. J Neurol Neurosurg Psychiatry 1990; 53: 106–113.Google Scholar
6. Kocen, RS Tuberculous meningitis. Br J Hosp Med 1977; 8: 443–448.Google Scholar
7. Schon, F, Bowler, JV Syringomyelia and syringobulbia following tuberculous meningitis. J Neurol 1990; 237: 122–123.Google Scholar
8. Fehlings, MG, Bernstein, M Syringomyelia as a complication of tuberculous meningitis. Can J Neurol Sci 1992; 19: 84–87.Google Scholar
9. Williams, B The cystic spinal cord. J Neurol Neurosurg Psychiatry 1995; 58: 649–654.Google Scholar
10. Newman, PK, Terenty, TR, Foster, JB Some observations on the pathogenesis of syringomyelia. J Neurol Neurosurg Psychiatry 1981; 44: 964–969.CrossRefGoogle ScholarPubMed
11. Nogués, MA Syringomyelia and syringobulbia.In: Myrianthopoulos, NC, ed. Handbook of Clinical Neurology.Elsevier Science Publishers Amsterdam BV 1987, vol 6(50): 443–464.Google Scholar
12. Savoiardo, M Syringomyelia associated with post meningitic spinal arachnoiditis. Neurology 1976; 26: 551–554.Google Scholar
13. Gouri-Devi, M, Satischandra, p Haluronidase as an adjuvant in the management of tuberculous spinal arachnoiditis. J Neurol Sci 1991; 102: 105–111.Google Scholar
14. Schapira, M, Presas, JL, Speiser, E, etal. Acute paraplegia and intramedullary cavitation in a patient with pulmonary tuberculosis. Medicina B Aires 1992; 52: 560–562.Google Scholar
15. Adams, RD, Victor, M Principles of Neurology. 5th edition New York: McGraw Hill, 1993; 484–485.Google Scholar
16. Berger, JR Tuberculous meningitis. Curr Op Neurol 1994; 7: 191–200.Google Scholar