Rao G P, Nadh B R, Hemaratnan A, Srinivas T V, Reddy P K
Department of Neurosurgery, Osmania Medical College, Hyderabad, Andhra Pradesh, India.
J Neurosurg. 1995 Aug;83(2):359-62. doi: 10.3171/jns.1995.83.2.0359.
The peculiar phenomenon of paradoxical progression during the treatment of central nervous system tuberculosis is discussed. A few cases with this phenomenon were reported in the past, and the authors have treated four such cases. During the treatment for tuberculous meningitis, the four patients developed new lesions, mainly in the form of tuberculomas, which progressed for some time and later regressed. In all these cases the initial drug regimen was not changed, except for the addition of steroids for a short period at the time of deterioration. All four patients underwent ventriculoperitoneal shunt insertion during the course of treatment. The authors discuss the significance of the changes in the lesions and management of such cases, and review the literature.
本文讨论了中枢神经系统结核治疗过程中出现的矛盾性进展这一特殊现象。过去曾有少数几例报道过这种现象，作者治疗了4例此类病例。在结核性脑膜炎治疗期间，这4例患者出现了新病变，主要表现为结核瘤，病变进展一段时间后又消退。在所有这些病例中，初始药物治疗方案未改变，仅在病情恶化时短期加用了类固醇。所有4例患者在治疗过程中均接受了脑室腹腔分流术。作者讨论了病变变化的意义及此类病例的处理方法，并对文献进行了综述。
