50 Patients With Tuberculous Meningitis Retrospective Analysis

Objective:Analysis the clinical characteristics laboratory detection,imaging examination and treatment options of tuberculous meningitis,in order to provide reference for early diagnosis and treatment.Methods:Retrospective analysis on January 1,2011 to January 1,2014(3years) from Lanzhou University Second Hospital clinical diagnosis of tuberculous meningitis treated first of the clinical data of 50 cases.ResuIts:①50 cases of tuberculous meningitis patients,30 cases of male (60.0%),women in 20 cases (40.0%),and to see more young and middle-aged peasants.11 cases of acute onset,accounted for only 22.0%.The main clinical manifestations and signs were headache(84.0%) and meningeal stimulation (58.0%).9 cases (18.0%) patients with nerve damage in different degree of brain, especially the abducens nerve.②Cerebrospinal fluid examination changes rate was 100.0%.Increased with increasing pressure in the rate of 58.0%,protein 96.0%,reduce the rate of glucose and chloride 76.0% and 84.0% respectively,an eleated count rate was 82.0%.③Head CT or MRI was abnormal in a total 35(70.0%),cortical or subcortical multiple abnormal signals most (30.0%),followed by hydrocephalus (16.0%),again for the strenthening of the meninges or brain pool (12.0%).Merger of extracranial TB 15 cases (30.0%),12 cases of pulmonary tuberculosis (24.0%).Another 7 cases of patients were misdiagnosed,the misdiagnosis rate was 14.0%.④all the patients were treated with anti-tuberculousis,44 cases (88.0%)patients with adrenal cortical hormone adjuvant therapy.Conclusion:(1)The most commom clinical symptoms and signs of tuberculous meningitis is headache and meningeal stimulation.(2)Cerebrospinal fluid examination and imaging examination is an improtant means of tuberculous meningitis,extracranial TB screening can not allow to ignor also.(3)Early anti-tuberculous treatment and auxiliary application of glucocorticoid treatment is the key to improve the cure rate and redece mortality.