Objective  To explore the clinical features of multiple intracerebral tuberculoma and its treatment.    Methods  Thirteen cases admitted in our department from January 2002 to December 2008 were retrospectively analyzed

and their medical data

radiography

cerebrospinal fluid study and pathological feature were evaluated. Meanwhile

their diagnosis and treatment were discussed in combination with literatures.   Results  The clinical presentations mostly consisted of fever

headache

and focal neurological deficits such as drowsiness (4/13)

hemiparesis (4/13)

convulsion (3/13)

ophthalmoplegi

a (3/13) and mild meningeal signs (8/13). Cerebrospinal fluid assay results showed that the pressure of CSF elevated (10/13)

protein elevated (12/13)

glucose decreased (9/13)

chlorine (Cl) decreased (7/13) and normal (6/11) WBC count or moderately elevated (7 /11). CSF cytology showed that 2 cases had combined cells reaction and 3 cases had lymphocyte-monocyte reaction. MRI revealed that multiple nodules or diffuse solitary lesions (13/13). Immature tuberculoma showed hypointense signal on T

1

WI and hyperintense signal on T

2

WI and nodular enhancement after contrast injection

and were surround by obvious edema tissue. Some cases showed typical target sign on T

2

WI. Histopathological examination revealed tuberculosis granulomatous inflammation in 6 cases and 2 cases of positive anti-acid staining. After standard treatment with antituberculosis drug and surgery operation

11 cases were recovered and 2 cases died.    Conclusion  The characteristics of cerebrospinal fluid assay and MRI images play important role in the diagnosis of brain multiple tuberculoma

and positive diagnosis  should be identified through brain histopathologic examination. The antituberculosis drug treatment is efficient but it must be standard and in a long term.