Epidural Tuberculous Abscess of the Posterior Cerebellar Fossa Extending To the Cervical Spine: An Unusual Form of Central Nervous System Tuberculosis in Children

Slimani S, Harmoumi Y, Bakali H, Salam S, Chbani C, Laoudiyi D and Ouzidane L

Published on: 2021-04-09

Abstract

We report the case of a twelve-year-old girl with a central nervous system (CNS) epidural tuberculous abscess (TBA) sitting in the posterior cerebellar fossa (PCF) with a cervical spine extension. CNS TBA is a rare form of CNS tuberculosis (TB) even in countries where TB is endemic. Diagnosis is mostly guided by magnetic resonance imaging, although formal evidence of a TBA is histological. Few medically treated cases of TBA of the PCF have been reported. Our patient did not respond to antitubercular treatment alone even after one year of treatment, which is consistent with the available data in the literature favoring surgery in PCF TBA.

Learning Points: Surgery is the first-line treatment for tuberculous abscesses of the cerebellar fossa. MRI is the imaging modality of choice in cases of suspected CNS tuberculosis infection. The emergence of resistance to antitubercular drugs should lead to greater caution before their use in case of suspicion of CNS TB.