Abstract
Tuberculous meningitis is rarely followed by the development of syringomyelia even after apparently successful chemotherapy. In the present paper, we report two cases with tuberculous meningitis who developed syringomyelia of a late onset. The two patients developed syringomyelia between 22 years and 23 years after the onset of tuberculous meningitis, respectively. One patient with syringobulbia who suffered long time without diagnosis of syringomyelia died three years after diagnosis from aspiration pneumonia. MRI of the patient showed the syrinx at the C1-2 and brainstem and the severe atrophy of the spinal cord below C3. MRI of the other patient demonstrated a large intramedullary cavity extending from T2 to L1. Syringoperitoneal shunt was performed. The operation was successful by neuroradiological criteria. Clinically the spastic gait and the sensory disturbance were improved and there was no recurrence one year after operation. Neuroradiological findings and etiology of the syrinx are discussed, and a causal relationship to tuberculous meningitis is proposed.
