• Annals of Clinical Neurophysiology
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• v.4 no.2
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• pp.140-145
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• 2002

Neurologic sequelae of tuberculous meningitis include hemiparesis, paraparesis, quadriparesis, aphasia, developmental delay, dementia, blindness, visual field defect, deafness, cranial nerve palsies, epilepsy, and hypothalamic and pituitary dysfunction. But cervical epidural abscess and cervical spondylitis are rare. A 64-year-old woman who was diagnosed as tuberculous meningitis presented a severe neck pain and stiffness after 3 weeks of anti-tuberculous medication. Electromyography and cervical X-ray showed a cervical spondylosis with polyradiculopathy. But cervical MRI showed an acute cervical epidural abscess and mild cervical spondylitis. After continuous anti-tuberculous medication with supportive care, she showed a slow clinical improvement. But about 1 month of anti-tuberculous therapy, she presented a more aggravation of neck pain, neck stiffness, radicular pain, and neck motion limitation. Follow-up cervical MRI showed an more advanced cervical spondylitis. Afterthen she has recovered slowly by cervical laminectomy with posterior stabilization and continuous anti-tuberculous medication.

• The Journal of Internal Korean Medicine
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• v.25 no.2
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• pp.352-360
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• 2004

Tuberculosis, one of the oldest diseases known to affect humans, is caused by bacteria belonging to the Mycobacterium luberculosis complex. The diseases usually affects the lungs, although in up to one-third of cases other organs are affected. If properly treated, tuberculosis caused by drug-susceptible strains is curable in virtually all cases. If untreated, the disease may be fatal within 5 years in more than half of cases. Transmission usually takes place through the airborne spread of droplets of nuclei produced by patients with infectious pulmonary tuberculosis. Two patients with Pulmonary Tuberculosis and one with Tuberculous Meningitis were recently examined. The changes in these patient's symptoms through both western medical treatment and oriental medical treatment are reported.

• Annals of Clinical Neurophysiology
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• v.7 no.1
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• pp.52-54
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• 2005

Tuberculous radiculomyelitis (TBRM) is a complication of tuberculous meningitis (TBM), which has been reported rarely in the modern medical literature. We describe a case of TBRM, which developed during the treatment of TBM. A 28-year-old man suddenly developed lower back pain, flaccid paraparesis, urinary incontinence, while the TBM was improving with the treatment at 9th day after admission. Spinal MRI revealed leptomeningeal enhancement along with thoracolumbar spinal canal, thickening of nerve roots, spinal meninges and intramedullary high signal lesion in T2 level.

• Investigative Magnetic Resonance Imaging
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• v.20 no.3
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• pp.200-205
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• 2016

In Korea, tuberculosis is still common disease. Central nervous system tuberculosis can manifest in a variety of forms, including tuberculous meningitis, tuberculous cerebritis, tuberculoma, tuberculous abscess, and miliary tuberculosis. Although intra-axial tuberculomas are the more common type of CNS tuberculosis, extra-axial lesions are rarely encountered. En plaque tuberculoma is an extremely rare presentation of intracranial tuberculosis with mimicking primary or secondary meningeal neoplasia. We describe a rare case of an en plaque tuberculoma accompanied by tuberculous meningitis and tuberculomas.

• Pediatric Infection and Vaccine
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• v.4 no.1
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• pp.64-72
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• 1997

Purpose : The incidence of tuberculous meningitis in Korean children has been markedly decreased after 1980s, but this disease has still occurred with low rate. Therefore, it may be suspected that delayed diagnosis and treatment will be happened because of lacking of clinical experiences and indistinguishable other meningitis, so it is important to make early diagnosis and treatment of tuberculous meningitis concerning with the prognosis. In this aspect, we conducted study to concern and investigate sustainly about the diagnostic criteria, clinical characteristics, radiological findings, complications, and prognosis of typical or atypical tuberculous meningitis in children. Methods : Forty four children who were hospitalized and treated due to tuberculous meningitis in pediatric wards of Our Lady of Mercy Hospital, St. Holy Hospital, St. Vincent Hospital and Uijungbu St. Mary Hospital from January 1985 to June 1996 were included in this study. We reviewed medical records of these patients retrospectively. Results : 1) The tuberculous meningitis has occured continuosly since mid-1980s. The highest 2) The diagnosis was made by contact history of active tuberculous patients, positive tuberculin test, responses of antituberculous antibiotics and discovery of Mycobacterium tuberculosis from CSF or other specimens. Among patients, 7 children(16%) were not vaccinated with BCG, and only 18 children(40%) were positive in tuberculin test. 3) The symptoms and signs of our patients on initial examinations were fever, vomiting, headache, lethargy, poor feeding, weight loss, neck stiffness, convulsion, abdominal pain and motor deficits. 4) The findings of initial CSF samples revealed leukocyte $239.5/mm^3$(mean) with lymphocyte predominant, elevated protein levels(mean;259.5mg%) and low sugar level(mean;40.7mg%). And the ratio of CSF/blood sugar was 0.407. But, atypical CSF findings were seen in 31.8% patients. 5) On brain imaging study, 34 out of 39 children had findings of hydrocephalus, basilar meningeal enhancement, infarction and subarachnoidal inflammations etc. On chest X-ray, the findings of miliary tuberculosis(34.1%), normal finding(29.5%), parenchymal infiltrations (11.4%) and calcifications(9.1%) were showed. 6) In neurological clinical stage, there were twenty-six children(59%) in stage 1, fourteen children(32%) in stage 2 and four children(9%) in stage 3. The late sequeles were encountered by 29.5% with mild and 4.6% with severe neurological injury. The most common neurological injury was quadriplegia and the mortality rate was 6.8%. 7) The SIADH was developed in 20 children(45.5%) after the 4th hospital day. Half of all SIADH patients were symptomatic. Conclusion : Tuberculosis meningitis is still an important extrapulmonary disease with high morbidity and mortality. Early diagnosis with clinical contact history of active tuberculosis and radiological imaging examinations and early treatments are essential in order to prevent and decrase the rate of late sequeles and death.

• Tuberculosis and Respiratory Diseases
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• v.51 no.6
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• pp.603-608
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• 2001

Intracranial vasculitis is a rare and disastrous complication of tuberculous meningitis if not treated properly. Focal neurologic deficits according to the vessels involved are common manifestation. Here, we report a 29-year-old man who suffered abrupt, bizarre behavioral changes caused by vasculitis complicating tuberculous meningoencephalitis. The diagnosis of tuberculous meningitis is based upon both the CSF findings and a chest X-ray. His systemic symptoms disappeared by after being administered antituberculous medication but various psychotic features such as hypersomnia, hyperphagia and aggressive behavior continued. A brain MRI showed multiple small parenchymal tuberculous nodules, and the brain MR angiography revealed a narrowing of the proximal middle cerebral arteries and a reduced visualization of the cerebral vessels, suggesting widespread vasculitis. Intravenous dexamethasone successfully ameliorated his behavioral changes. In addition both the follow up brain MRI and angiography showed a normalization of the previous findings.

• Tuberculosis and Respiratory Diseases
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• v.59 no.3
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• pp.306-310
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• 2005

Hyponatremia which is due to excessive sodium loss in the urine and decrease in extracellular fluid volume following an acute or chronic central nervous system injury, has been conjunctively described as cerebral salt wasting syndrome (CSWS). This syndrome is often confused with dilutional hyponatremia due to inappropriate secretion of antidiuretic hormone. Accurate diagnosis and management are mandatory for improvement of the course of the disease. This report describes a case of a 31-year-old male patient with CSWS associated with tuberculous meningitis. The patient exhibited hyponatremia, polyuria, excessive natriuresis, volume depletion, and hypotension. He was diagnosed to manifest CSWS and was treated by administration of fluids, salt, and fludrocortisone. After the respective treatments, symptoms of polyuria and hypotension were gradually resolved and hyponatremia was corrected.

• Journal of Yeungnam Medical Science
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• v.4 no.1
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• pp.139-143
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• 1987

The clinical picture and CSF findings in cryptococcus meningitis may be identical with those of tuberculous meningitis. The differential diagnosis can be made by finding the budding yeast organism in the counting chamber or in stained smear, the detection of cryptococcal antigen in CSF by the latex agglutination test, and by culture of the fungus on Sabouraud agar. We experienced a case of cryptococcal meningitis in the 48 years old woman, which was confirmed by Indian ink preparation and culture.

• Pediatric Infection and Vaccine
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• v.9 no.1
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• pp.117-121
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• 2002

Although the incidence of intracranial tuberculosis in children have been decreased with development of antituberculous therapy, mortality rate is still high as formerly if the diagnosis and treatment was not performed early. Authors report a case of a 5-month old male with multiple intracranial tuberculoma who have been accompanied by miliary tuberculosis and tuberculous meningitis. He was hospitalized at the pediatric department of Wonkwang University Hospital with mild fever and persistent cough. The brain MRI was performed and showed that there were multiple intracranial micronodular densities, perinodular edema and diffuse leptomeningeal enhancement which were disappeared completely after antituberculosis chemotherapy for 12 months and he had completely recovered without sequale.

• Clinical and Experimental Pediatrics
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• v.52 no.5
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• pp.622-626
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• 2009

Kikuchi-Fujimoto disease was initially described as a self-limiting histiocytic necrotizing lymphadenitis in Japan in 1972, and is predominantly observed in women under the age of 30 year and in Asian populations. The pathogenesis is still poorly understood but is thought to include infections, and autoimmune and neoplastic diseases. The most common clinical manifestations are fever and painless cervical lymphadenitis. Diagnosis is based on the histopathological findings, characterized by focal necrosis in the paracortical region with abundant karyorrhexis, aggregates of atypical mononuclear cells around the zone of necrosis, absence of neutrophils and plasma cells, and usually intact lymph node capsule. There is no specific therapy for the condition, and aseptic meningitis can occur as one of the complications. Here, we report the case of a patient with Kikuchi-Fujimoto disease accompanied with aseptic meningitis, which may be confused as a case of tuberculous meningitis and lymphadenitis.