Abstract: Objective To explore the early clinical features of tuberculous meningitis as well as the laboratory tests and imaging demonstrations so as to improve the diagnosis of the disease. Methods The clinical data of 95 cases who were firstly diagnosed with tuberculous meningitis in our hospital from January 2012 to September 2017 were retrospectively analyzed. Results The presenting symptoms included fever, headache, nausea, vomiting and meningeal irritation. Cerebrospinal fluid examination revealed increased count of nucleated cells with predominating lymphocytes, increased level of protein, decreased levels of sugar and chloride. The peripheral blood T-SPOT was positive in 56% of the cases. Brain imaging commonly demonstrated meningeal enhancement, cerebral infarction, hydrocephalus and tuberculoma. A total of 82 patients showed improved condition after treatment, and the condition of 12 patients deteriorated. Death occurred in 1 case. Conclusion Adult tuberculous meningitis is more common in middle-aged and elderly population. The clinical manifestations and , cerebrospinal fluid changes are non-specific. Etiological examinations show a low detection rate. And early diagnosis and timely treatment play important role in improving the prognosis of the disease.

Key words: Tuberculous meningitis, Clinical analysis, Diagnosis, Cerebrospinal fluid