Beruflich Dokumente
Kultur Dokumente
Case Material
Tubercuious Meningitis
Fig. 2. -Tuberculoma in young
Nine of the 12 patients had tubenculous meningitis. girl. A, Well defined low density
area adjacent to left lateral yen-
None of these nine had associated evidence of tubercu- tricle. B, Homogeneous en-
lomas. Tuberculous meningitis results from the hema- hancement of left lateral ventri-
cle with iodinated contrast me-
togenous dissemination of bacilli from a primary tuber-
dia. Note associated hydroceph-
culosis lesion in the thorax, abdomen, or genitouninary alus. C, Marked
reduction in size
tract. It affects mainly the very young and the very old, and in enhancement after 6
months of antituberculous thor-
with the highest incidence in the first 3 years of life [1]. apy.
In the majority of patients, the disease evolves gradually.
Prodromal symptoms include apathy, anorexia, vomit-
ing, and headache. The headache becomes more intense
and prolonged, and neck stiffness develops. There may
be photophobia, irritability, fever, convulsions, stupor,
coma, and decerebrate rigidity. Cranial nerve dysfunc- specific findings are almost pathognomonic. These
tions, such as sudden onset of a unilateral or bilateral changes reflect, respectively, the basilar fibninous pach-
cranial nerve palsy on sudden catastrophic cerebral on ymeningitis and the vasculitis that characterize this dis-
spinal neurologic deficits, in association with these non- ease process [2].
Prior to 1900, tubenculomas constituted one-third of nervous system tuberculosis: a persistent disease. J Neu-
nosurg 34:15-22, 1971
all intracranial tumors and more than half of intracranial
3. Enzman DR. Normal D, Mani J, Thomas H: Computed
tumors in children [5, 6]. A more recent review [7]
tomography of granulomatous basal arachnoiditis. Radio!-
demonstrated an incidence of 0.15%. The incidence is
ogy 120:341-344, 1976
still fairly high in certain countries (e.g.. 15% in Chile; 4. Lorber J: Intracranial calcification following tuberculous
30.5% in Bombay) [8]. Tuberculous involvement of other meningitis in children.Acta Radio! 50:204-210, 1958
organs or a history of tuberculosis contact is present in 5. Thrush DC, Barwick DD: Three patients with intracranial
50%-75% of all cases [9]. tuberculomas with unusual features. J Neurol Neunosung
CT IN CRANIAL TUBERCULOSIS 771