Tsuji A, Tokuriki Y, Takebe Y, Kizuki H, Handa J
Department of Neurosurgery, Fukui Red Cross Hospital.
No Shinkei Geka. 1998 Mar;26(3):233-8.
A 49-year-old male with tuberculous meningitis was reported. When admitted to our hospital with mild right hemiparesis, he was alert but he developed disorientation 7 days later. A diagnosis of tuberculous meningitis was reached because of elevated levels of adenosine-deaminase at 19.6U/liter in the cerebrospinal fluid. MRI showed a marked enhancement in the basal cisterns and an enhanced intraparenchymal lesion in the brainstem. Chronological changes of MRI findings did not closely correlate with the clinical course. Slight meningeal enhancement on MRI seems to remain for a long time without active tuberculous meningitis, and absence of the meningeal enhancement on MRI is not necessarily appropriate as a marker of cure of tuberculous meningitis.
报告了一名49岁患有结核性脑膜炎的男性。他因轻度右侧偏瘫入院时意识清醒，但7天后出现定向障碍。由于脑脊液中腺苷脱氨酶水平升高至19.6U/升，诊断为结核性脑膜炎。MRI显示脑基底池明显强化，脑干实质内有强化病灶。MRI表现的时间变化与临床病程并不密切相关。MRI上轻微的脑膜强化在无活动性结核性脑膜炎的情况下似乎会长期存在，而MRI上脑膜强化的缺失不一定适合作为结核性脑膜炎治愈的标志。
