Early syringomyelia in tubercular meningitis: A rare occurrence.

Tubercular meningitis (TBM) can have varied early and delayed complications involving brain or spinal cord. Although syringomyelia can occur sometimes as a late complication of tubercular meningitis, its occurrence in early stages of TBM is very rare. There are only two published case reports of syringomyelia in acute stage of TBM. We report a patient with tubercular meningitis who developed syringomyelia in early disease course. A 26-year-old female presented with history of fever, severe headache and vomiting for last two and half months. Patient’s history and clinical examination was suggestive of chronic meningitis with raised intracranial pressure. Cerebrospinal fluid analysis showed evidence of TBM. Patient was started on antitubercular drugs and during treatment course she developed acute onset motor weakness of all four limbs. Magnetic resonance imaging (MRI) showed long segment syrinx extending from C3 to T3 region. After thecoperitoneal shunting there was improvement in motor power.