多发性脑结核瘤13例临床分析  

Clinical analysis on 13 cases with multiple intracranial tuberculomas

作　　者：李淑艳[1] 刘国利[1] 吴海良[1] 战云飞[1] 杨效光 

机构地区：[1]山东省胸科医院,济南250013

出　　处：《中国防痨杂志》2011年第5期280-283,共4页Chinese Journal of Antituberculosis

摘　　要：目的探讨多发性脑结核瘤的临床特点及诊断治疗方法。方法回顾性分析2004年1月—2007年12月诊治的13例多发性脑结核瘤。结果患者的主要临床表现以头痛、发热和呕吐居多,头痛11例,发热10例,呕吐7例。脑脊液压力增高8例,细胞数异常11例。10例合并颅外结核。颅脑MRI检查中8例报告为T1W1等信号,T2W1为低信号。3例开颅脑组织活检证实为结核性肉芽肿。采用强化抗结核、激素和鞘内注射等综合治疗,获很好的疗效。结论脑内多发性结核瘤是一种特殊类型的颅内结核病变,综合其临床表现、影像学和脑脊液检测等特点有助于临床诊断。采用强化抗结核、激素和鞘内注射等综合疗法为佳。Objective To investigate the clinical features and the methods of diagnosis and treatment for multiple intracranial tuberculomas. Methods 13 patients with multiple intracranial tuberculomas were retrospectively analyzed from January 2004 to December 2007 in Shandong Chest Hospital. Results The clinical presentations mostly consisted of headache（11/13）,fever（10/11）,vomiting（7/11） and increased intracranial pressure（8/13）.Cell count from cerebral spinal fluid（CSF） was high in 11 cases.Extracranial tuberculosis were combined in 10 cases.Magnetic resonance imaging（MRI） showed iso-intense signal on T1-weighted imaging and hypo-intense signal on T2-weighted imaging.Histopathologic examination revealed tuberculosis granulomatous inflammation in 3 cases.Using comprehensive therapy including intensive anti-tuberculosis regimen,hormone and intrathecal injection with drugs,efficacy was satisfactory. Conclusion Multiple intracranial tuberculomas is a special type of intracranial tuberculosis.Combination with its clinical,manifestation radiological features and CSF result,clinical diagnosis is helpful to be established.Comprehensive therapy including the intensive anti-tuberculosis regimen,hormone and intrathecal injection with drugs is recommended.

关 键 词：结核瘤 颅内/诊断 结核瘤 颅内/药物疗法 

分 类 号：R529.3[医药卫生—内科学]