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结核性脊神经根脊髓炎(蛛网膜炎)合并结核性脑膜炎。

Tuberculous radiculomyelitis (arachnoiditis) associated with tuberculous meningitis.

作者信息

Chotmongkol Verajit, Kitkuandee Amnaj, Limpawattana Panita

机构信息

Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

出版信息

Southeast Asian J Trop Med Public Health. 2005 May;36(3):722-4.

Abstract

Abstract. A 17-year-old man who presented with progressive quadriparesis is reported. About 8 months prior to admission, he had miliary tuberculosis, and that improved with anti-tuberculous therapy. He had also developed tuberculous meningitis and tuberculous myelitis, respectively. He regularly took anti-tuberculous drugs until this illness. Neurological findings were compatible with cervical cord lesion. CSF analysis indicated a predominate lymphocytic pleocytosis with a high protein level and low sugar profile. MRI findings revealed a multi-loculated arachnoid cyst at C1-C3 level with pressure affecting the adjacent spinal cord and evidence of myelitis at C3-T1 level. Hemi-larminectomy and removal of the arachnoid cyst were performed, but without improvement. A CSF culture yielded M. tuberculosis, that was susceptible to anti-tuberculous drugs.

摘要

摘要。报告了一名出现进行性四肢瘫痪的17岁男性。入院前约8个月,他患有粟粒性肺结核,经抗结核治疗后病情好转。他还分别患上了结核性脑膜炎和结核性脊髓炎。在此次发病前他一直在规律服用抗结核药物。神经系统检查结果与颈髓病变相符。脑脊液分析显示以淋巴细胞为主的细胞增多,蛋白水平高,糖含量低。磁共振成像结果显示C1 - C3水平有多房性蛛网膜囊肿,对相邻脊髓产生压迫,且C3 - T1水平有脊髓炎迹象。进行了半椎板切除术并切除了蛛网膜囊肿,但病情并无改善。脑脊液培养检出结核分枝杆菌,该菌对抗结核药物敏感。

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