There is considerable clinical and experimental evidence to suggest that the hypersensitivity response of the leptomeninges to tuberculoprotein is a major factor in the course of tuberculous meningitis.1 The intrathecal injection of tuberculin in nonsensitized subjects causes no significant meningeal reaction, whereas in those sensitized it produces a marked pleocytosis in the cerebrospinal fluid,2 which apparently reflects an acute nonspecific meningitis because of hypersensitivity of the leptomeninges to the presence of tuberculoprotein.Likewise, it has been found that the injection of living tubercle bacilli into the cisterna magna of rabbits induced an immediate inflammatory meningeal reaction only in those animals which had already been successfully sensitized by subcutaneous injections of tuberculoprotein.3,4 It seems that this nonspecific allergic inflammation may be the dominant factor and one determining the gravest clinical signs in the very early stages of tuberculous meningitis of acute onset in humans.5In view
FELDMAN S, BEHAR AJ, WEBER D. Experimental Tuberculous Meningitis in Rabbits: II. Effect of Hydrocortisone on the Hypersensitivity Reaction of the Meninges. Arch Neurol. 1960;3(4):420–424. doi:10.1001/archneur.1960.00450040070010
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