本文报告4例小儿严重结核性脑膜炎。一例死亡,二例遗留严重神经后遗症。回顾了结核性脑膜炎(以下简称结脑)的临床症状和诊断原则。治疗包括联合使用口服异烟肼—利福平和乙胺丁醇,或当口服不可能时用异烟肼—乙胺丁醇,乙硫异烟胺静脉注射。对严重病例,用利福霉素SV椎管内注射。皮质激素应用的适应症是:颅内压增高伴脑水肿,失败的 This article reports 4 cases of severe tuberculous meningitis in children. A case of death, two cases left serious neurological sequelae. Review the clinical symptoms and diagnosis of tuberculous meningitis (hereinafter referred to as knot brain). Treatment includes the combination of oral isoniazid - rifampicin and ethambutol, or intravenous injection of isothionine - ethambutol, ethionamide, when not possible orally. Serious cases, with rifamycin SV spinal injection. Indications for corticosteroid use are: Increased intracranial pressure with cerebral edema, failure