Central nervous system tuberculosis: a persistent disease

Abstract

✓ The authors report their experience with four recent cases of tuberculosis affecting the central nervous system (CNS), including tuberculous meningitis and tuberculomas of both the cerebrum and the cerebellum. They emphasize that antituberculous drugs have given the neurosurgeon a role of increased importance and effectiveness in the management of CNS tuberculosis. Shunts, radical excisions, and fusion have new significance. Angiography and brain scans may reveal operable lesions. The authors believe that CNS tuberculosis should always include triple therapy with INH, PAS, and streptomycin plus corticosteroids to control cerebral edema and help to minimize basilar adhesions and hydrocephalus in tuberculous meningitis.