Intramedullary and intradural-extramedullary spinal tuberculomas causing spinal cord compression is an uncommon entity. We report an unique case of a 27-year-old Indian male patient on 4 drug  antituberculous  chemotherapy for tubercular meningitis , who presented  after two months with rapidly progressive unilateral  lower limb monoparesis  with loss of  pain and temperature in the contralateral limb but intact  position and vibration sense. MRI spine showed a single intramedullary  tuberculoma at D2-D3 level, might causing brown sequard syndrome, associated with multiple intradural-extramedullary tuberculomas  in thoracic and cervical region with arachnoiditis. MRI brain showed no evidence of intracranial tuberculoma. In our case the patient was given high dose steroid to which he responded and later  discharged on antituberculous  therapy and oral steroids. This case is being reported owing to its rarity of its presentation as brown sequard syndrome and co-occurrence of both intramedullary and intradural-extramedullary tuberculomas in an immunocempetent  patient.

Keywords: Intramedullary, Intradural-extramedullary Tuberculoma, Brown-Sequard-Syndrome

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Pratibha Prasad

M.D. Gen Medicine, Department of General Medicine,

Institute of Medical Science, Banaras Hindu University

Varanasi – 221005, Uttar Pradesh , India