Intramedullary spinal cord abscess

Intramedullary tubercular abscess is a very rare condition, however it needs to be considered in the differential diagnosis of neurological deterioration in a patient of tuberculosis as timely intervention often gives good neurological recovery. The authors report a rare case of intramedullary tuberculous abscess of dorsal spinal cord in a 35-year-old female patient who presented with paraplegia and bladder involvement. Magnetic resonance imaging scans revealed D6-D10 arachnoiditis with intramedullary lesion with extradural compression locally. A dorsal laminectomy with decompression of intramedullary abscess with biopsy of extradural granulation tissue was carried out and patient was started on antituberculous therapy and gradually improved neurologically postoperatively. Intrameduallry tuberculous abscess is a rare condition and surgical intervention is helpful even in the presence of profound neurological deficits

Arachnoiditis mimicking recurrent spinal ependymoma

Spinal arachnoiditis is a cause of persistent symptoms or recurrence of symptoms in 6-16% of postoperative patient. Spinal arachnoiditis mimicking ependymoma tumour recurrence in a young child is reported here. A 9-year-old child was operated 3 years back for extensive lumbar and sacral ependymoma. He presented with short history of rapidly progressive paraparesis and radiology was stongly suggestive of recurrent tumour in lumbar spinal canal. However, surgery revealed only CSF loculation in the spinal canal. No tumour was seen. The patient improved after adhesiolysis. Postoperative spinal arachnoiditis can mimic tumour recurrence in ependymomas. This is an interesting case observed by us and we advise that the possibility of spinal arachnoiditis should be kept in mind in the differential diagnosis of causes of neurological deterioration in previously operated cases of ependymoma