CONCLUSIONS:
Intradural extramedullary (IDEM) tuberculoma is a rare manifestation of central nervous system (CNS) tuberculosis, often arising as a result of paradoxical reactions to antitubercular medication. When patients on antitubercular therapy develop new-onset neurological deficits indicative of compressive myelopathy, IDEM tuberculoma should be considered as one of the potential causes. Early and accurate diagnosis, along with timely initiation of appropriate medical or surgical interventions, is crucial to prevent irreversible dysfunction. Excision plays a pivotal role in the treatment of this uncommon condition.