Abstract
5year-old boy was admitted to our service with the chief complaints of the remittent fever (38-39°C), neck stiffness, vomiting and headache on Aug. 2, 1975. He was treated as having puru lent meningitis for over 2 months prior to admis sion to our service.His general condition was improved but findings of his cerebrospinal fluid remained unchanged. On Oct. 11, he had a clonic seizure of the right side of the body.EEG exami nation.brainscintigraphy and left carotid angio graphy revealed mass lesion in his left parietal lobe.Craniotomy was performed on his left pari etal region on Nov.4 (th). There was an abscess in the left parietal lobe and the capsule was re moved totally. The histological examination of the capsule presented a typical findings of tuber culous lesion. Subsequently the administration of Streptomycin.Isonicotinic acid hydrazide and Etanbutol and Rifampicin were instituted. For the increased intracranial pressure.removal of bone flap. the ventricular drainage and a ventri culoperitoneal shunt were done.The patient was discharged without neurological deficit except total blindess on May.21.1976. and maintained his health up to present (May.1978).
Tuberculous meningitis is very few nowadays and the cases of tuberculous meningitis with brain abscess formation seemed to be extremely rare and fatal in most of the cases.
A conservative therapy is made for tuberculous meningitis.But the mortality is high and the sequelae caused by the increased intracranial pressure is serious. If the ventricular drainge is made at the chronic stage.the mortality and the sequelae will decrease.
It is our impression that neurosurgical mana gement was essential for the diagnosis and the successful treatment in this case.
