Abstract

Background: Tuberculosis (TB) is still an endemic disease in many parts of the world. Central nervous system involvement is common. TB of the central nervous system can have diverse presentations and is often misdiagnosed due to its nonspecific clinical presentation and varied radiology. Spinal cord tuberculoma, a rare manifestation of extrapulmonary TB, poses a significant challenge in clinical management due to its complex presentation and the potential for severe and urgent neurological complications.
Case Presentation: A 59-year-old male was presented with progressive tetraparesis due to a cervical spinal cord tuberculoma. Magnetic resonance imaging showed an intramedullary lesion at C6 with necrotic features. Due to rapid neurological deterioration, surgical excision was performed, confirming tuberculoma on histopathology. Postoperatively, the patient was started on anti-tuberculous therapy, leading to gradual neurological improvement.
Conclusion: Spinal cord tuberculoma should be considered in the differential diagnosis of intramedullary lesions. Surgical excision provides both diagnostic confirmation and therapeutic benefit in cases of significant neurological compromise. This challenge arises from its intricate presentation and the potential for severe neurological consequences.

Key words: Tuberculosis, cervical cord, central nervous system, extrapulmonary lesions, case report