Clinical Study on Tuberculous Meningitis (Correlation with brain CT findings)

We tried to correlate brain CT findings with clinical state at admission and outcome at discharge in 42 selected cases from 94 adult patients under the diagnosis of tuberculous meningitis at Seoul National University Hospital during last four years from 1981. Their clinical state at admission and outcome at discharge were classified into three groups by severity of symptoms, respectively. The final outcome of them were well correlated with their clinical states at admission. Observed abnormal brain CT findings in this series were hydrocephalus (74%), dirthy cisternal enhancement (52%), infraction (38%), periventricular low density (36%), and tuberculoma (19%). The poorer the clinical state at admission and outcome at discharge, the more frequent the abnormal brain CT findings, especially of periventricular low density and infraction. But periventricular low density without infarction seemed to affect more deleterious effect on clinical state at admission than on final outcome.

Effect of Steroid Treatment in Myasthenia Gravis

Twenty-one myasthenic patients were treated with high-dose daily prednisone regimen at Seoul National University Hospital from May 1983 to January 1985. Observations in relation to dosage, drug schedule, clinical responses, and sideeffects led us to following conclusions concerning the management of myasthenia gravis with steroid. In addition, factors influencing the result were considered. 1) Among 21 patients, twenty(95%) showed clinical improvement of variable degrees. 2) Significant improvement could be expected especially in male patients, in older patients, and in those with duration of myasthenia gravis less than 6 months prior to treatment. Performance of thymectomy or thymothymectomy, thymic pathology, and clinical grade at the time of therapy were not considered to affect the outcome. 3) Ten cases (48%) suffered from initial exacerbations, most of which occurred within the first four days of treatment. Steroid-induced crises developed in four cases with preexisting brittle or severe generalized myasthenia. 4) Period taken to show the initial response and the maximum improvement varied widely but majority of them occurred within 15 days and 70 days respectively. 5) Off-day weakness during the alternate-day schedule required special cautions and, if persitent, immediate return to daily schedule was desirable. 6) Thymectomy prior to steroid treatment was not always necessary but, when both regimens were scheduled together, preparation therapy with steroid thought to be more favorable. 7) Aside from initial exacerbations side-effects during the treatment were not remarkable, all of which disappeared with reduction of dosage.

One case of Intracranial Sparganosis

No abstract available.

Brain CT Findings in Wilson Disease

Brain computed tomographic findings in 4 cases of Wilson disease were analysed. All subjects were diagnosed by biochemical assays of copper metabolism and presence of Kayser-Fleisher rings. The results were as followings: 1. Brain CT findings were abnormal in all. Low densities in lenticular nuclei were observed in three cases. Cortical atrophy with ventricular dilatation was observed in three cases. Cerebellar atrophy was observed in one case. In one case, cerebellar atrophy was revealed as main feature. In another one, cortical atrophy with ventricular dilattion was revealed as main feature. 2. After contrast enhancement, faintly enhancing nodules were observed in two cases. One showed ill-defined enhancing nodules in frontal and parietal areas and the other showed a rim enhancing nodule with surrounding low density in left frontal area. 3. Neurologic symptoms of the patients were relatively well correlated with their brain CT findings. Such symptoms did not improved after treatment. It is probably due to irreversible brain damage.

A case Report of Mollaret's Meningtis

A 52-year-old woman with a history of at least 5 attacks of benign recurrent aseptic meningitis for the past 2 years is presented. Three of 5 attacks were afrebrile. In cerebrospinal fluid examinations, there was increased protein, normal or reduced glucose, and pleocytosis including endothelial cells, lymphocytes or leukocytes. Brain computed tomography revealed slight ventricular dilatation. No causative organism was found with available techniques. This is believed to be the first reported case of Mollaret's meningitis in Korea.