Tuberculous meningitis (hereafter referred to as tuberculosis) is an inflammatory disease of the meninges caused by Mycobacterium tuberculosis and accounts for about 6% of systemic tuberculosis. In recent years, its morbidity and mortality have been increasing. If the disease is not diagnosed and treated promptly, it can lead to serious neurological complications and eventually lead to death or severe disability. In general, the duration of tuberculosis from onset to death is about 3-6 weeks, and it is the most important cause of pediatric tuberculosis death. Compared to other diseases, the treatment of tuberculosis is more difficult. So what are the main points to be considered in the treatment of tuberculosis? 1, nodular brain treatment should be used as early as possible The effect of nodular brain treatment is closely related to early diagnosis and early treatment. We have observed clinically that the earlier the nodular brain is treated, the faster the recovery and the fewer the sequelae. And it is a pity that some patients lose the best time for treatment due to unknown diagnosis or misdiagnosis as other meningitis, which delays the treatment time. Therefore, patients with a clinically confirmed diagnosis should be treated promptly with powerful anti-tuberculosis drugs. For patients whose diagnosis is not clear but cannot completely exclude nodular brain, family members can ask the hospital for diagnostic anti-tuberculosis treatment to avoid delaying the disease. If diagnostic anti-tuberculosis treatment is given for 3 weeks and the patient’s condition does not improve, the tuberculosis drugs can be discontinued and other causes can be further investigated. 2.Tuberculosis treatment should be combined with drugs The reasonable combination of multiple anti-tuberculosis drugs for tuberculosis treatment can improve the efficacy, reduce drug toxicity, and delay or even prevent the emergence of drug resistance of Mycobacterium tuberculosis. Isoniazid, rifampin, ethambutol and pyrazinamide are the basic drugs. The combination of isoniazid, rifampin, ethambutol and pyrazinamide is used during the consolidation period, and para-aminosalicylic acid can be added in patients with severe disease. During the consolidation period, the combination of isoniazid and rifampin is usually sufficient. The oral medication is generally best taken in a single day amount on an empty stomach. The main reason why nodules are prone to recurrence is that they cannot adhere to long-term medication. We often encounter some nodular brain patients in the clinic because the headache symptoms disappear or feel nothing serious after taking the medication for a year and then stop the medication on their own, resulting in a relapse of the disease and re-admission to the hospital. The currently accepted treatment course for nodular brain is 1.5-2 years, and the relapse rate can be minimized. The intensive period requires hospitalization until cerebrospinal fluid tests are normal before discharge for consolidation. The intensive period is usually 3 months, which can be extended by 4-6 months in severe cases, and the consolidation period is 18-21 months. The patient’s family should supervise the patient to adhere to the medication, and the hospital should also strengthen the education of patients with nodular brain and regular follow-up visits. 4, nodular brain treatment to use good hormone in the early onset of nodular brain anti-tuberculosis drugs combined with adrenocorticotropic hormone (referred to as hormone) has become a conventional method of nodular brain treatment. The use of hormones has the following benefits: (1) suppressing inflammatory reaction and anti-fibrotic tissue formation; (2) rapidly reducing tuberculosis toxicological symptoms and meningeal irritation; (3) lowering brain pressure, reducing cerebral edema and preventing obstruction of the spinal canal. However, the amount of hormone should not be too large, generally 30mg of prednisone orally or 5mg of dexamethasone intravenously every day, and the amount can be gradually reduced after the headache disappears and the cerebrospinal fluid examination tends to improve, and the course of treatment is 6-12 weeks. During the use of hormones, attention should be paid to the protection of gastric mucosa, and additional drugs such as famotidine should be used to prevent gastric mucosal bleeding.