Katti Muralidhar K
Immunology Laboratory, Department of Microbiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram 695 011, India.
Med Sci Monit. 2004 Sep;10(9):RA215-29. Epub 2004 Aug 20.
Cerebral tuberculosis or tuberculosis of the brain manifests predominantly as tuberculous meningitis followed by tuberculoma, tuberculous abscess, and other concomitant forms such as cerebral miliary tuberculosis, tuberculous encephalopathy, tuberculous encephalitis, and tuberculous arteritis. Different forms of cerebral tuberculosis are mainly caused by Mycobacterium tuberculosis and also by non-tuberculous mycobacteria such as M. avium-intracellulare in human immunodeficiency virus-infected persons. Cerebral tuberculosis is diagnosed based on clinical features, cerebrospinal fluid studies combined with radiological images. Early diagnosis, prompt institution of anti-tubercular treatment, and the clinical stage at which the patient presents are important and deciding factors for final outcome. The present review highlights the pathogenesis, recent strides made in diagnosis, including sensitive and specific molecular diagnostic (immunologic and polymerase chain reaction) tests, treatment, and outcome aspects of cerebral tuberculosis.
脑结核或脑部结核病主要表现为结核性脑膜炎，其次是结核瘤、结核脓肿以及其他伴随形式，如脑粟粒性结核、结核性脑病、结核性脑炎和结核性动脉炎。不同形式的脑结核主要由结核分枝杆菌引起，在人类免疫缺陷病毒感染者中也可由非结核分枝杆菌如鸟分枝杆菌复合群引起。脑结核根据临床特征、脑脊液检查并结合影像学图像进行诊断。早期诊断、及时开始抗结核治疗以及患者就诊时的临床阶段是决定最终结局的重要因素。本综述重点介绍了脑结核的发病机制、诊断方面的最新进展，包括敏感和特异的分子诊断（免疫和聚合酶链反应）检测、治疗以及预后情况。
