结核性脑膜炎48例误诊分析

目的总结结核性脑膜炎误诊的原因及其教训。方法对48例误诊的结核性脑膜炎回顾分析其一般情况、临床表现、脑脊液检查及影像学资料。结果误诊为血管性头痛22例,神经性头痛14例,偏头痛8例。椎—基底动脉供血不足4例。误诊时间(36±8)d。结论肺部结核证据较少,症状不典型,病情进展缓慢是误诊的主要原因;询问病史不详细、分析病情不全面是误诊的重要教训。

Analysis on Misdiagnosis of 48 Patients with Tuberculous Meningitis

Objective To summarize the causes and the lesson for the misdiagnosis of tuberculous meningitis. Methods Retrospective analysis was conducted in 48 patients with tuberculous meningitis who were not diagnosed correctly at first. Results The disease was misdiagnosed as vascular headache in 22, as neural headache in 14, as migraine in 8, and as shortage of vertebral and basilar artery blood flow in 4 paitents. The mean time during which the patients were misdiagnosed lasted 36 (36±8) days. Conclusion It is due to pulmonary tuberculosis' less evidence, clinically atypical symptom and slow development that tuberculous meningitis is misdiagnosed. Doctors should learn their lesson of careless history collection and incomplete analysis on the disease status.