关键词: 结核瘤；　结核感染；　脑；　脊髓

Abstract: Objective　To explore the clinical characteristics of multiple tuberculosis infection in the central nervous system. Methods　The clinical data of concurrent multiple intracranial and intraspinal tuberculomas with tuberculous meningitis and miliary pulmonary tuberculosis in one child were retrospectively analyzed and the related literature was reviewed. Results　An 8-year-old boy had a miliary distribution of cerebral tuberculomas. The number of lesions was more than 30, involving cerebral hemisphere, cerebellar hemisphere, thalamus, brain stem, and eye bundle. In addition, the child had intramedullary tuberculomas, tuberculous meningitis and miliary pulmonary tuberculosis. The child recovered after one year of anti-tuberculosis treatment. Seven cases of intracranial and intramedullary tuberculomas were found by a literature search, including one case with optic bundle involvement and one case with tuberculous meningitis. Six cases had subacute or chronic onset and 1 case had acute onset. None of the 7 children had significant manifestations of cerebral tuberculosis, but all of them showed the signs of spinal cord compression. Five children were complicated with acute miliary tuberculosis (or tuberculosis). One child was diagnosed with tuberculous meningitis, and brain and spinal tuberculosis appeared after treatment. One patient developed new tuberculoma during treatment. All children recovered well after the anti-tuberculosis treatment. Conclusions 　The early diagnosis of brain and spinal tuberculoma needs to combine clinical manifestations, imaging features, evidence of extracranial tuberculosis and effective anti-tuberculosis treatment. Early diagnosis and timely treatment can improve the prognosis.

Key words: tuberculoma;　tuberculosis infection;　intracranial;　intramedullary