Türk Nöroşirürji Dergisi 2010 , Vol 20 , Num 2
Paraplegia Due to Intradural Tumor Like Spinal Neurobrucellosis Granuloma
Melih ÇEKİNMEZ1, Kadir TUFAN2, Feyzi Birol SARICA3, Yusuf Ziya DEMİROĞLU4, Nihat Berkay KÖKSOY5, Bülent ERDOĞAN6, Mehmet Nur ALTINÖRS7
1,2,3,5,6,7 Başkent Üniversitesi, Tıp Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dalı, Ankara, Türkiye
4 Başkent Üniversitesi, Tıp Fakültesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Ankara, Türkiye
AIM: Brucellosis is a zoonosis caused by Gram negative bacteria, Brucella spp. Disease is highly prevalent in developing countries. Central nervous system involvement is rare though neurological symptoms are frequent.

MATERIAL and METHODS: The patient was a 47-years old female who presented to a healthcare center for low back pain and difficulty in walking and had MRI of the lumbar spine that showed an intradural mass at the level of L4. Patient was operated but the lesion could be excised subtotally and, therefore referred to our hospital. Lumbar MRI taken in our hospital showed residual intradural. During the operation, when the dura was opened, pus was observed and samples were taken for microbiological and pathological examination considering the possibility of an infectious process. Brucellosis was diagnosed by postoperative tests and antimicrobial treatment was initiated, which resulted in rapid improvement of the patient's neurological symptoms. Antimicrobial treatment and physical treatment and rehabilitation of the patient was planned and patient was discharged.

CONCLUSION: Brucella granulomas should be considered in differential diagnosis of intradural masses in endemic regions. Surgery should be the first choice in treatment of cases with neurological deficit followed by antimicrobial treatment at appropriate dose and spectrum. Anahtar Kelimeler : Brucellosis, Granuloma, Neurobrucellosis, Spinal cord granulomas