Intramedullary tuberculoma of the thoracic spine presented as paraparesis: A rare case report

Tuberculosis (TB) is a bacterial infection with Mycobacterium tuberculosis which primarily affects the lungs; however, it can affect any organ in the body. Brain tuberculous infection usually comes via hematogenous spread from a pulmonary focus and rarely via direct spread from ear, cranial vault or spine. It can present in various conditions including the following: tuberculous meningitis (TBM), brain or spinal cord tuberculoma, miliary TB, tuberculous abscess, tuberculous encephalopathy, and even intracranial hemorrhage. Here, we report an extremely rare case of intramedullary spinal cord tuberculoma in a 30-year-old man presented with paraparesis in a patient under treatment for TBM. Our case report highlights that tuberculoma should be considered as a differential diagnosis for intramedullary space occupying lesions. The clinical features and medical imaging supplemented by advanced magnetic resonance imaging techniques helps in evaluating different types of tuberculous lesions and in making the diagnosis of brain and spine TB confidently.