Background: tuberculosis meningoencephalitis (TBME) is an acute infectious disease of the central nervous system. The disease had a high mortality rate and severe sequelae if late diagnosis and not timely treatment. However, in recent years, the patients with TBME who was transferred to National Pediatric Hospital Hospital remained to be diagnosed not exactly, affect to treatment outcomes. Objectives: study on the difficulties in diagnosing TBME in children. Subjectives and Method: a descriptive study on 34 children aged 4-14 months diagnosed with TBME at Department of infectious, National Pediatric Hospital from January 2002 to September 2005. Results: 35.29% of the patients were under 1 year old. The suggestive signs and symptoms for diagnosis included BCG\ufffd?scar (50%), tuberculosis exposure (32.4%), weight loss (31.8), fever (100%), vomiting (70.6%), stiff-neck (94.1%), meningeal sign (70.6%), Kernig\u2019s sign (61.8%), positive Tuberculin tests (35.29%) and typical lesions on chest x-rays (11.8%). In cerebrospinal fluids (CSF), mean cell count was 274/mm3 and protein concentration was 1.51g/l. These were hindrances for diagnosing TBME in children. Disease distribution was in both the urban and the rural areas. Conclusions: Clinical manifestations and disease progress are not typical for TBME diagnosis. Therefore, it is important to think about TBME in cases with acute meaningitidis lasting for more than 14 days. PCR will be a very good marker for definite diagnosis.
Meningoencephalitis/ diagnosis ; Tuberculosis ; Meningeal/ diagnosis ; Child ;

Humans ; Meningeal Neoplasms/diagnosis* ; Meningioma/diagnosis* ; Staining and Labeling

Meningeal tumor obstructing the foramen magnum is relatively rare, moreover occurrence of such a tumor in children has rarely been reported. This tumor shows various characteristic clinical manifestations, partly from anatomical standpoint and partly from unknown mechanism. In addition, not uncommon remitting and relapsing clinical course often presents diagnostic conflicts. We experienced a case of basilar groove meningioma presenting many difficult problems in the diagnosis and treatment, which was confirmed at operation and subsequent autopsy in a child.
Autopsy ; Child* ; Diagnosis ; Foramen Magnum ; Humans ; Meningeal Neoplasms ; Meningioma*

We tried to correlate brain CT findings with clinical state at admission and outcome at discharge in 42 selected cases from 94 adult patients under the diagnosis of tuberculous meningitis at Seoul National University Hospital during last four years from 1981. Their clinical state at admission and outcome at discharge were classified into three groups by severity of symptoms, respectively. The final outcome of them were well correlated with their clinical states at admission. Observed abnormal brain CT findings in this series were hydrocephalus (74%), dirthy cisternal enhancement (52%), infraction (38%), periventricular low density (36%), and tuberculoma (19%). The poorer the clinical state at admission and outcome at discharge, the more frequent the abnormal brain CT findings, especially of periventricular low density and infraction. But periventricular low density without infarction seemed to affect more deleterious effect on clinical state at admission than on final outcome.
Adult ; Brain* ; Diagnosis ; Humans ; Hydrocephalus ; Infarction ; Seoul ; Tuberculoma ; Tuberculosis, Meningeal*

CT is a valuable method in determining number, location and extent of lesions, although a definite diagnosisis often not possible on CT. In intracranial tuberculosis, CT was helpful in the diagnosis, assessing the degreeof hydrocephalus and evaluating the effectiveness of antituberculous therapy. Twenty-one cases of clinical lyproven intracranial tuberculosis were studied by CT in our hospital during last 3 years. Of them, eighteen caseswere tuberculous meningitis and the rests were tuberculoma. The results were as follows; 1. Tuberculous meningitis presented the following three patterns of CT findings according to its disease process. a. In early stage of the disease, suspcious multiple isodense small nodules in the cerebral and cerebellar hemispheres showed dense enhancement in postcontrast scan representing miliary tubercles. b. In later stage of the disease, precontrastscan showed partial or total obliteration of the basal and sylvian cisterns with mild dilatation of ventricularsystem. Postcontrast scan showed dense enhancement of basal and sylvian sisterns. This type of finding was themost common in our series. c. Moderate to marked dilatation of ventricle with or without a cluster ofcalcifications in suprsella area on precontrast scan was seen in far later stage or as a sequellae of the disease. No enhancement was noted in postcontrast study. 2. Tuberculoma showed an isodense or slightly hyperdense area inthe cerebral or cerebellar hemisphere with associated minimal edema in precontrast study. Postcontrast scan showeda small ring enhancement with central lucent area.
Diagnosis ; Dilatation ; Edema ; Hydrocephalus ; Methods ; Tuberculoma ; Tuberculosis ; Tuberculosis, Meningeal

A 24-year-old man with tuberculosis meningitis developed acute paraplegia and sensory disturbances 5 weeks after receiving conventional antituberculous therapy. Magnetic resonance imaging revealed an intradural extramedullary long segmental mass mimicking en plaque meningioma at the T2-T6 vertebrae levels. Prompt surgical decompression was performed. A histology examination of the mass revealed a tuberculoma. After surgery, the patient showed improved motor power and a normal bladder function. Intradural extramedullary tuberculoma of the spinal cord is rare complication of tuberculosis meningitis, which can occur as a response to conventional antituberculous therapy.
Diagnosis, Differential ; Humans ; Male ; Meningeal Neoplasms/*diagnosis ; Meningioma/*diagnosis ; Spinal Cord Diseases/*diagnosis/surgery ; Thoracic Vertebrae ; Tuberculoma/*diagnosis/surgery ; Tuberculosis, Meningeal/*diagnosis/surgery ; Young Adult

A suprasellar meningioma with multiple intratumoral cysts in a 6-month-old boy is reported. A review of literature disclosed only 11 cases so far. They showed a characteristic predominance in males and predominance of fibroblastic type on pathological examination. Intratumoral cystes are less common than peritumoral cysts. The various hypothesis regarding cyst formation are discussed.
Case Report ; Cysts/diagnosis/*pathology ; Human ; Infant ; Male ; Meningeal Neoplasms/diagnosis/*pathology ; Meningioma/diagnosis/*pathology

Humans ; Magnetic Resonance Imaging ; Male ; Meningeal Neoplasms ; diagnosis ; pathology ; Meningioma ; diagnosis ; pathology ; Middle Aged

Adult ; Female ; Humans ; Meningeal Neoplasms ; complications ; diagnosis ; Meningioma ; complications ; diagnosis ; Otitis Media with Effusion ; diagnosis ; etiology ; Skull Base Neoplasms ; complications ; diagnosis

We report a rare case of a patient with Moyamoya syndrome who presented with intracerebral hemorrhage resulting from rupture of a middle meningeal artery pseudoaneurysm. This 38-year-old woman was unconscious and hemiplegic when she was admitted to our hospital. The patient had mental retardation as a result of tuberculous meningitis infection at the age of one year. On radiologic examination, she had intracerebral hemorrhage in the right temporo-parietal lobe and an aneurysm in the middle meningeal artery with right internal carotid artery occlusion. The patient underwent surgical treatment for the hemorrhage and aneurysm. The radiologic data, intraoperative findings, and pathology were consistent with a diagnosis of pseudoaneurysm. In the current report, we describe a rare case of a patient with a history of tuberculous meningitis who developed Moyamoya syndrome and pseudoaneurysm, which resulted in a ruptured middle meningeal artery pseudoaneurysm and brain hemorrhage.
Adult ; Aneurysm ; Aneurysm, False* ; Carotid Artery, Internal ; Cerebral Hemorrhage ; Diagnosis ; Female ; Hemorrhage ; Humans ; Intellectual Disability ; Intracranial Hemorrhages ; Meningeal Arteries* ; Moyamoya Disease* ; Pathology ; Rupture* ; Tuberculosis, Meningeal*