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Early Syringomyelia, A Rare Complication of Tubercular Meningitis: A Case Report

Shankar Roy , Anirudh Mukherjee , Sukdev Manna, Minakshi Dhar,  Megha K Mukundan and Mahendra Meena

Tubercular meningitis (TBM), the most common form of central nervous system tuberculosis, has the potential to
cause varied early and delayed neurologic complications including hydrocephalus, cranial nerve palsies, vasculitic
infarction, arachnoiditis and tuberculoma at any part of brain or spinal cord. Early syrinx formation in TBM is very
rare especially when a patient is on anti-tubercular drugs. Here we report a case of 30-years-old male patient with 2
months history of fever with headache and 2 weeks history of neurological abnormalities with a background history
of ATT intake for 3 weeks without steroid. He was found to have TBM based on positive CSF-CBNAAT report.
Diagnostic work up with neuroimaging (CEMRI brain with spinal cord) for new onset neurological symptoms showed
tuberculoma with early formation of syrinx in the dorso-lumbar region of spinal cord. Patient responded well to
conservative management with ATT and steroid. Unique nature of this case lies in the fact of development of such
rare complication early in disease course and is proposed to be due to failure of early administration of steroid.