[A case of posttraumatic severe ventriculitis treated by intraventricular lavage]

A 44-year-old male was admitted in a state of semicoma, tonic convulsion and elevated body temperature nine days after sustaining head injury. He had severe nuchal rigidity. Computed tomography revealed dilation of ventricles and swelling of the brain parenchyma. We performed cerebrospinal fluid (CSF) drainage of both lateral ventricles immediately. The fluid drained from both ventricles was just like pus. We diagnosed the patient's condition as posttraumatic ventriculitis and meningitis. We performed intraventricular lavage (IL) which was our ventricular irrigating technique. IL was repeated until the 7th day postoperatively. The CSF data improved immediately. Continuous spinal drainage (CSD) also was used for CSF drainage from the 7th day postoperatively. The patient recovered without the need for CSF shunt. Some authors have reported the usefulness of continuous intraventricular irrigation (CIVI) for treatment of severe ventriculitis. However, their patients required CSF shunt surgeries. Such shunts are likely to become infected more frequently than routine shunting. Our IL was able to drain pus and inflammatory products in the ventricles before the formation of septations in the ventricles. We emphasize that IL in combination with CSD is able to bring about good results for patients with severe ventriculitis.