An unusual triad: tuberculomas, tubercular meningitis, and hydrosyringomyelia in a child from a suburban region

Central nervous system (CNS) tuberculosis is a rare but serious manifestation of Mycobacterium tuberculosis infection, especially in the paediatric population. We report a rare case of an eight year old male child from a suburban region presenting with intracranial tuberculomas, tubercular meningitis, and spinal hydrosyringomyelia (HSM). Magnetic Resonance Imaging (MRI) revealed multiple brain tuberculomas, basal exudates, abnormal meningeal enhancement, spinal HSM with features of arachnoiditis. The patient was operated for removal of tuberculomas and placement of ventriculo-peritoneal (V-P) shunt and responded well to antitubercular therapy and corticosteroids.Tuberculosis should be considered in the differential diagnosis in children presenting with unexplained neurological symptoms in endemic regions. Early neuroimaging is critical in avoiding morbidity and permanent neurological damage.