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Case Reports
. 2014 Jul-Sep;9(3):173-6.
doi: 10.4103/1793-5482.142740.

A extremely rare case of cervical intramedullary granuloma due to Brucella accompanied by Chiari Type-1 malformation

Kadir Tufan  1 , Fatih Aydemir  1 , Feyzi Birol Sarica  1 , Ebru Kursun  2 , Özgür Kardes  1 , Melih Cekinmez  1 , Hakan Caner  1
Affiliations
Case Reports

A extremely rare case of cervical intramedullary granuloma due to Brucella accompanied by Chiari Type-1 malformation

Kadir Tufan et al. Asian J Neurosurg. 2014 Jul-Sep.

Abstract

Chiari Type-1 malformation is displacement of the cerebellar tonsils through the foramen magnum into the cervical spine and usually does not exceed the level of C2. It is 50-70% associated with syringomyelia. Nervous system involvement due to brucellosis is called neurobrucellosis, and neurological involvement rate has been reported an average of 3-5%, ranging between 3% and 25% at different series. Intramedullary abscess or granuloma due to Brucella is extremely rare. Hence far, six cases have been reported in the literature and only two of these cases were reported as intramedullary granuloma. This case is presented in order to remind the importance of the cervical cord granuloma which was presented once before in the literature and to emphasize the importance of evaluation of patient history, clinical and radiological findings together in the evaluation of a patient.

Keywords: Brucella; Chiari Type-1 malformation; cervical region; spinal intramedullary granuloma.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
(a) Sagittal T2-weighted, b) sagittal contrast-enhanced T1-weighted and (c) axial contrast-enhanced T1-weighted cervical spinal magnetic resonance imaging revealed Chiari malformation Type-1 and syringomyelia and/or spinal cord edema which is hyperintense on T2-weighted series and isointense on T1-weighted series between C2 and C4 vertebral levels, nodular enhancing intramedullary lesion at the level of C2 vertebra
Figure 2
Figure 2
At 6 months of treatment, the patient's complaints and neurological examination completely resolved and granuloma was found to be completely disappeared, and minimal edema was seen on cervical spinal magnetic resonance imaging; (a) sagittal T2-weighted and (b) sagittal contrast-enhanced T1-weighted
See this image and copyright information in PMC

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