Cassleman E S, Hasso A N, Ashwal S, Schneider S
J Comput Assist Tomogr. 1980 Apr;4(2):211-6. doi: 10.1097/00004728-198004000-00016.
Three cases are used to illustrate the computed tomography (CT) findings of tuberculous meningitis in infants and children. The clinical and laboratory findings of these patients are presented, and the differential diagnosis of viral, bacterial and fungal meningitis is reviewed. Tuberculous meningitis should be suspected, even in the infant or child with a negative tuberculin skin test, when a chronically ill patient presents with the acute signs of meningismus, the cerebrospinal fluid analysis demonstrates a low glucose and monocytosis, and cranial CT shows ventricular enlargement with prominent basal and sylvian fissure enhancement after intravenous contrast medium injection. The ease and safety of serial CT examinations make this procedure the ideal radiological method to follow the patient's course in order to evaluate the response to treatment.
本文通过三个病例阐述婴幼儿结核性脑膜炎的计算机断层扫描（CT）表现。文中呈现了这些患者的临床及实验室检查结果，并对病毒性、细菌性和真菌性脑膜炎的鉴别诊断进行了综述。对于慢性病患儿，若出现急性脑膜刺激征，脑脊液分析显示葡萄糖水平降低且单核细胞增多，静脉注射造影剂后头颅CT显示脑室扩大伴基底节和外侧裂强化明显，即便结核菌素皮肤试验结果为阴性，也应怀疑结核性脑膜炎。连续CT检查操作简便且安全，使其成为评估患者病情进展及治疗反应的理想影像学检查方法。
