All issues > Volume 34(10); 1991

Original Article

J Korean Pediatr Soc. 1991;34(10):1391-1399. Published online October 31, 1991.

Brain CT and clinical finding in tuberlous meningitis.

Moon Chan Kim¹, Chan Yung Kim²

¹Department of Pediatrics, Kosin Medical College, Pusan, Korea
²Department of Pediatrics, College of Medicine, Pusan National University, Pusan, Korea

Received: March 18, 1991;  Accepted: June 7, 1991.

Abstract

In this study, we evaluated clinical symptoms, neurologic findings, CSF examinations and prognosis of patients who were diagnosed to have tuberculous meningitis at Pusan National University Hospital and Gospel Hospital from march, 1983 to december, 1989. 1) Mean age was 3 years and 8 months and the percentage of patients under 6 years old was 71.9%. The male to female ration was 2.2:1. 2) Fever and vomiting were the most common symptoms, comprizing 66.7% of patients. Drowsy, vomiting, fever, neck stiffness, convulsion or hemiparesis were presented in stage 2, and stupor or coma in stage 3. 3) The ratio of negative findings in Mantoux test was 21.9%, and the more the clinical stage progressed, the higher the percentage was. 40.7% of these patients had pulmonary tuberculosis and 9. 4% had miliary tuberculosis. In CSF examination, WBC counts and protein were elavated and glucose concentration was decreased. 4) In brain CT findings, 6 cases (18.8%) of granuloma, 9 cases (28.1%) of enhancement of basal cistern, 9 cases (28.1%) of infarction and 29 cases (90.6%) of hydrocephalus were found. There were small numbers of patients with enhancement of ambient cistern, obliteration of basal cistern, cerebral atrophy and hemorrhage. 5) Among the 32 patients, 15 cases (46.9%) were recovered without suqueles, 8 cases (25.0%) had residual sequeles such as cerebral palsy, personality change, mental retardation, blindness, seizure, etc. 9 cases (28.1%) were poor prognosis who expired, discharged with moribund state or discharge against medical advice.

Keywords :Tuberculous meningitis;Brain CT