Tuberculous meningitis is quite a common disease and delay in treatment is associated with poor prognosis. But the study on the prognosis f tuberculous meningitis is rare inKorea.
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 (3.3%)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 nad vomiting in 71 cases (44.7%), altered consciousness in 38 cases(23.9%) in order and clinical stage onadmission
revealed
83 cases of stage 1, 62 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%0, pulmonary tuberculosis (13.8%), spinal tuberculosis (3.1%0, renal tuberculosis and so on .
4. Comparing with those who have not developed neurological sequelae on discharge, the mean pretein value of cerebrospinal fluid on 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 (14.85) and tuberculous granulomas in 8 cases(6.6%).
5. 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.
6. Prognosis of tuberculous meningitis appeared to be related to the neurological status, protein value of cerebrospinal fluid on admission as well as hydrocephalus in brain computed tomography scan.
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