颅内结核瘤的诊治及误诊分析

目的 探讨颅内结核瘤的诊治及误诊原因。方法回顾性分析24例颅内结核瘤患者的临床资料。结果24例中13例行显微外科手术，2例行立体定向活检术并经病理证实，术后均给予正规抗结核治疗；9例经抗结核保守治疗有效。11例术前未考虑结核瘤，误诊率为46％。结论 临床病史结合辅助检查多可确诊颅内结核瘤。手术治疗辅以术后正规抗结核治疗，预后良好。颅内结核瘤临床表现无特征性，影像学特征不典型，是常常导致误诊的主要原因。

Diagnosis, treatment and misdiagnosis analysis of intracranial tuberculoma

Objective To explore the diagnosis, treatment and misdiagnosed reasons of intracranial tuberculoma. Method The clinical data of 24 cases with intracranial tuberculoma treated in our department from January 1997 to May 2010 were analyzed retrospectively. Results In all 24 cases, 13 cases underwent surgical treatment,2 cases underwent stereotactic biopsy and were confirmed by pathological examinations. 9 cases were regularly treated with anti - tuberculosis drugs. 1 1 cases of intracranial tuberculoma did not be diagnosed echinococcosis before operation, with the misdiagnosis rate of 46％. Conclusions Intracranial tuberculoma is usually diagnosed based on clinical history with auxiliary inspections. With drug consolidate treatment after operation, the prognosis is good. Non - characteristic clinical features, non - characteristic radiographic manifestations contribute to misdiagnosis.