급성 경추 경막외 농양 및 경추척추염과 동반된 결핵성 수막염 1예

A Case of Tuberculous Meningitis Combined with Acute Cervical Epidural Abscess and Cervical Spondylitis

  • 이동국 (대구가톨릭대학교 의과대학 신경과학교실)
  • Lee, Dong Kuck (Department of Neurology, School of Medicine, Catholic University of Daegu)
  • 발행 : 2002.11.30

초록

Neurologic sequelae of tuberculous meningitis include hemiparesis, paraparesis, quadriparesis, aphasia, developmental delay, dementia, blindness, visual field defect, deafness, cranial nerve palsies, epilepsy, and hypothalamic and pituitary dysfunction. But cervical epidural abscess and cervical spondylitis are rare. A 64-year-old woman who was diagnosed as tuberculous meningitis presented a severe neck pain and stiffness after 3 weeks of anti-tuberculous medication. Electromyography and cervical X-ray showed a cervical spondylosis with polyradiculopathy. But cervical MRI showed an acute cervical epidural abscess and mild cervical spondylitis. After continuous anti-tuberculous medication with supportive care, she showed a slow clinical improvement. But about 1 month of anti-tuberculous therapy, she presented a more aggravation of neck pain, neck stiffness, radicular pain, and neck motion limitation. Follow-up cervical MRI showed an more advanced cervical spondylitis. Afterthen she has recovered slowly by cervical laminectomy with posterior stabilization and continuous anti-tuberculous medication.

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