| 결핵성 수막염의 임상증상 및 휴유증 |
| 박재현, 김장성,최일생,이병인 |
| 인제대학교 신경과. 연세대학교 신경과. |
| Clinical Manifestations and Sequelae of Tuberculous Meningitis |
| Jae-Hyeon Park, M.D., Jang-Sung Kim, M.D., Il-Saing Choi, M.D., Byung-In Lee, M.D. |
| Department of Neurology, College of Medicine, Inje University, Department of Neurology, College of Medicine, Yoensei University |
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| Abstract |
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Tuberculous meningitis is qutie a common disease and delay in treatment is associated with poor prognosis. But the study on the prognosis of tuberculous meningitis is rare in Korea. We analyzed the clinical and laboratory findings of 159 cases seen between 1986 and 1990 at the Yonsei University College of Medicine, Severance Hospital. The specific aims of this study were to evaluate the clinical presentation, course and outcome and to determine the factors that may have influence on the outcome of tuberculous meningitis. The following results were obtained. 1. The highest incidence of age was noted in third decade as 37 cases (23.3%)and there was a tendency that the annual incidence of tuberculous meningitis declined since 1989. 2. The most presenting symptoms on admission were headache in 114 cases (71.7%), fever and chilling in 112 cases (70.4%), nausea and vomiting in 71 cases (44.7%), altered consciousness in 38 cases(23.9%) in order and clinical stage on admission revealed 83 cases of stage 2 and 14 cases of stage 3. 3. Associated tuberculous lesions other than central nervous system were found in 56 cases (35.2%) including miliary tuberculosis (15.7%), pulmonary tuberculosis (13.8%), spinal tuberculosis (3.1%), renal tuberculosis and so on. 4. Comparing with those who have not developed neurological sequelae on discharge, the mean protein value of cerebrospinal fluid on admission was increased and the mean glucose value and WBC count were decreased in patients who have developed neurological sequelae. 5. Brain computed tomography scan was performed in 122 cases and it revealed no abnormal findings in 54 cases (44.3%), enlarged ventricle in 44 cases (36.1%), basal enhancement in 25 cases (20.5%), lacunes in 18 cases (14.8%) and tuberculous granu-lomas in 8 cases (6.6%). 6. The neurological sequelae were developed in 53 cases (33.3%) including altered consciousness (13.2%), cranial nerve palsies (10.1%), death (5.0%), hemiparesis (4.4%), paraparesis(3.1%)and so on. 7. Prognosis of tuberculous meningitis app |
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