摘要
目的探讨中枢神经系统结核瘤的临床特点,提高临床诊疗水平。方法回顾性分析2002年1月至2010年12月7例患者的临床诊治资料。结果头痛、发热、体重下降和乏力是最常见的临床表现。1例患者脑脊液聚合酶链式反应呈阳性。所有患者影像学上均呈相类似的强化灶,绝大多数病灶都位于幕上,仅1例同时存在大脑和小脑的病灶。所有组织病理活检均提示肉芽肿性炎症伴中心干酪样坏死改变。初期每个患者都给予四联抗结核药物治疗3个月和糖皮质激素治疗1个月,维持期给予二联抗结核药物治疗18～24个月。6例治愈。结论中枢神经系统结核病原学检查阳性率低,确诊主要依靠组织病理诊断。规范治疗是取得成功的关键。
Objective To investigate the clinical features of eenWal nervous system tuberculoma for improving the level of diagnosis and treatment Methods The clinical data of seven patients of central nervous system tuberculoma from January 2002 to December 2010 were retrospectively analyze＆ Results Headache, fever, weight loss and weakness were the most commonly clinical manifestations. One patient had positive result in polymerase chain reaction （PCR） of cerebrospi- nal fluid. All patients had similar contrast-enhancing lesions radiologically. The majority of tuberculomas were located supmtentorially. One patient presented two foci of （cerebral and cerebellar） tuberculomas. Histopathologic examination revealed granulomatous inflammation with central caseous necrosis. Quadruple antituberculous drug were used for 3 months and glucocorticoid was used for 1 month for initial therapy, followed by 18-24 months of treatment with double antituberculous drug. Six patients were cured completely. Conclusion The positive rate of pathogens of central nervous system tuberculoma was low. The defirfitive diagnosis depends upon histopathologic examination. Normalized therapy is crucial for good outcome.
出处
《海南医学》
CAS
2013年第4期547-549,共3页
Hainan Medical Journal
关键词
中枢神经系统
结核瘤
干酪样坏死
肉芽肿性炎症
Central nervous system
Tuberculoma
Caseous necrosis
Granulomatous inflammation
