Fig. 4

Longitudinally extensive transverse myelitis due to tuberculosis in a 31-year-old female with a past history of treated tubercular lymphadenitis who presented to emergency with fever, altered sensorium, and paraparesis. CSF ADA levels were raised, measuring 24 IU/l (cut off: > 10 IU/l). Sagittal T2W image of dorsal spine (A) demonstrates a well-defined long segment area of hyperintensity (arrows) spanning the thoracic spinal cord. Axial post-contrast image (B) showing interrupted areas of subtle peripheral enhancement in the involved part of cord (arrow). Axial T2W image (C) of the brain shows obstructive hydrocephalus with dilated bilateral lateral and third ventricles and periventricular ooze due to tubercular meningitis