- 期刊
Late-Onset Cerebral Vasculitis with Tuberculous Meningitis: A Case Report
結核性腦膜炎難以避免的結核性腦血管炎：個案報告與文獻回顧
摘要
結核性腦血管炎是結核性腦膜炎嚴重的併發症之一。我們報導一名41歲的女子，一開始出現發燒和頭痛兩個星期後，疑似腦膜炎住院，檢驗腦脊髓液，發現細胞增多，以淋巴細胞為主。於住院第4日開始服用抗結核藥物和皮質類固醇，然後病情穩定，逐漸減少皮質類固醇劑量。在住院第30日發生結核性腦血管炎。給予增加皮質類固醇劑量與積極照護後，她的病情逐漸恢復。我們進行相關文獻回顧。在我們的案例中，即使使用皮質類固醇，我們依然要仔細注意那些會發生結核性腦血管炎的高風險患者。結核性腦膜炎患者，應採取適當的照顧，在照顧期間應注意結核性腦血管炎的出現。
關鍵字
無資料並列摘要
Tuberculous cerebral vasculitis (TCV) is a catastrophic complication of tuberculous meningitis (TBM). We report herein the case of a 41-year-old woman with TBM who presented with a fever and headache for 2 weeks. Cerebrospinal fluid analysis revealed pleocytosis with lymphocytic predominance. On admission day 4, an anti-tuberculosis regimen and oral prednisolone were initiated; on day 30, she developed TCV during tapering of the prednisolone dosage. After supportive care and an increased dosage of prednisolone, her condition gradually improved to normal. We suggest that TCV should be included in the differential diagnosis of any case of neurological deterioration arising during the course of TBM.