70Patients With Tuberculous Meningitis Retrospective Analysis

Objective:to analyse the clinical manifestations of tuberculous meningitis, cerebrospinal fluid characteristics, imaging, for the early diagnosis of tuberculous meningitis with guidance.Methods:retrospective analysis from January1,2006to January1,2012in the Affiliated Hospital of Jilin University for clinical diagnosis of tuberculous meningitis in70cases of patients with clinical data.Results:70cases of tuberculous meningitis patients,37cases were female,33were male, admitted when the main symptoms and signs:headache (88.6%), Xiang Qiang (80%), fever (76.7%), vomiting (60%), G type syndrome (56%) consciousness disorders or mental abnormalities (49%). In25cases of patients with cranial nerve damage performance, the abducens nerve damaged most. CSF check the change rate of100%, which increased intracranial pressure (66%), increased leukocyte (94%), protein (93%), glucose reducing (66%),(60%) chloride reduction. The positive rate of ADA (80%). Head CT or MRI examination was abnormal in40cases (57%), including intracranial infiltration leads to brain pool or meningeal enhancement was most common (34.3%), hydrocephalus (33%), the imaging manifestations and cerebral infarction, tuberculoma, tuberculous brain abscess and other.70patients were found in brain of patients with extrapulmonary tuberculosis in39cases (55.7), wherein the pulmonary tuberculosis patients with up to29(41.4%). In70cases there were10cases of patients admitted to the hospital early misdiagnosis as other diseases, including viral meningitis or encephalitis at most (60%), there are other misdiagnosed as vascular headaches, posterior circulation ischemia, brain tumor.Conclusion:(1) headache, fever, vomiting, Xiang Qiang, such as change of consciousness of clinical manifestations and symptoms in tuberculous meningitis is most common;(2) cerebrospinal fluid routine biochemical sometimes atypical, should be based on tuberculous meningitis complicated with pulmonary tuberculosis rate is high, the positive rate of head imaging higher features a comprehensive analysis;(3) Tuberculous Meningitis Misdiagnosed easily, should be the focus and viral meningitis, encephalitis phase differential.