Spinal Subdural Tuberculous Abscess

Objectives: Spinal subdural abscess is rare and only 48 cases have been described to date. In this report, we present an additional spinal subdural tuberculous abscess.

Method: Tuberculous meningitis was diagnosed with clinical and laboratory findings in a 45-year-old man. A spinal subdural abscess was demonstrated using MRI. Presence of the abscess was revealed by surgical intervention. The diagnosis was confirmed by pathological examination.

Results: The patient had been treated for tuberculous meningitis 2 years previously. The disease recurred when anti-tuberculous therapy was prematurely discontinued. During the second treatment, the patient also underwent a ventriculo-peritoneal shunt operation for hydrocephalus. Dizziness and weakness of both legs developed after the postoperative period. Spinal MRI showed a spinal subdural abscess as a iso-intense mass with spinal cord in the T1 and T2 weighted images, ring like enhancement and compression on the spinal cord at T3-T4 level. The patient underwent surgery and the abscess was drained.

Conclusion: Tuberculosis may cause a spinal subdural abscess and although it is a rare disorder, when encountered MRI is very useful in the diagnosis.