MRI contribution in intramedullary tuberculoma

Background. The spinal cord is a rare location for tuberculomas. Young adults are most often affected. The essential clinical symptom is spinal cord compression. From the magnetic resonance imaging (MRI) analysis of six patients, we show the characteristic of intra-medullary tuberculomas. Materials and methods. This is a retrospective study of six cases of intramedullary tuberculoma collected between 2003 and 2010, revealed by spinal cord compression and explored by MRI. The MRI protocol included the weighted sequences T1, T2, and T1 with gadolinium injection with axial and sagittal slices. HIV serology tests were made in all patients. Five of our patients had a biopsy with histopathology study. Results. Our study included four men and two women with an average age of 26 years. The location of the tuberculoma was cervical (n = 2), thoracic (n = 2) and in the conus medullaris (n = 2). Signal abnormalities were different, depending on the stage of the lesion. One case exhibited association between paravertebral abscess and cerebral tuberculoma. HIV serology was negative in all patients. The tuberculous origin was confirmed by biopsy in five patients. Conclusion. Intramedullary location of tuberculoma is rare and is an unusual cause of spinal cord compression in young, particularly immunocompetent, adults. MRI is a useful method of investigation for diagnosis and monitoring outcome.