[The course and outcome of tuberculous meningitis in adults]

The course and outcomes of tuberculosis of the central nervous system (CNS) in adults were studied comparatively within two 10-year periods i.e. from 1968 to 1977 and from 1978 to 1987. It was shown that within the last 10-year period the number of the adults with tuberculous meningitis had lowered while the proportion of the adults with tuberculosis of the CNS among all the patients with that form of tuberculosis had remained unchanged. There was no increase in the number of the patients of the elderly and senile ages. Acute onset of the disease as well as asymptomatic and atypical onsets and courses were recorded. It was stated that association of tuberculosis of the CNS with active pulmonary tuberculosis became more frequent. Higher levels of neutrophilic-lymphocytic pleocytosis as compared to the previous ones, marked hypoglycorrhachia and more frequent isolation of mycobacteria from the liquor were noted. No increase in the efficacy of the treatment was stated. The death rate did not change. The situation should be explained by the incidence of common forms of pulmonary tuberculosis including fibrocavernous and disseminated tuberculosis, insufficient prophylaxis, the incidence of concomitant diseases, sometimes acute onset of the disease, asymptomatic process of the disease, inattention of physicians as to possible incidence of tuberculous meningitis.