Related Experiment Video
Updated: Sep 29, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Timing of shunt surgery in childhood tuberculous meningitis with hydrocephalus
Serdar Kemaloglu1, Umit Ozkan, Yaşar Bukte
1Department of Neurosurgery, School of Medicine, Dicle University, Diyarbakir, Turkey. mserdarkemaloglu@yahoo.com
Insights
Early ventriculoperitoneal shunting (VPS) improves outcomes for children with mild to moderate hydrocephalus due to tuberculous meningitis (TBM). This surgical intervention positively impacts morbidity and mortality in these pediatric cases.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Neurosurgery
Background:
- Hydrocephalus is a frequent complication of tuberculous meningitis (TBM) in children.
- Understanding the impact of treatment timing on outcomes is crucial for managing pediatric TBM.
Purpose of the Study:
- To review institutional experience with hydrocephalus in childhood TBM.
- To evaluate the effect of ventriculoperitoneal shunting (VPS) timing on patient outcomes.
Main Methods:
- Retrospective review of 156 pediatric patients diagnosed with TBM and hydrocephalus between 1990 and 2000.
- Analysis of outcomes based on early (2 days post-diagnosis) versus delayed (3 weeks post-diagnosis) VPS.
- Average follow-up period of 8.5 months.
Main Results:
- Overall, 52.6% of patients achieved good recovery or minor sequelae, while 12.3% died.
- Early VPS demonstrated a statistically significant positive effect on outcomes in mild and moderate hydrocephalus (p = 0.040).
- Early shunting showed a trend towards improved morbidity in severe hydrocephalus, though not statistically significant.
Conclusions:
- Early surgical intervention for mild/moderate hydrocephalus in childhood TBM positively influences morbidity and mortality.
- The timing of VPS is a critical factor affecting the final outcome in pediatric TBM with hydrocephalus.
Abstract:
Hydrocephalus is a common complication of tuberculous meningitis (TBM) in children. The aims of this study are to review our experience of hydrocephalus in childhood TBM and to evaluate the effect of the timing of ventriculoperitoneal shunting (VPS) on the final outcome. In this study, 156 patients with TBM and hydrocephalus were reviewed retrospectively between 1990 and 2000. Patients' ages ranged from 6 months to 15 years, with a mean age of 4.1 years. There were 85 boys, and the male-to-female ratio was 1.19:1.0. Sixty-two percent of the children were younger than 6 years old. VPS was performed 2 days after the diagnosis in 100 patients, and in the remaining 56 patients, 3 weeks after the diagnosis. The average follow-up period was 8.5 months. Good recovery or minor sequelae was seen in 82 patients (52.6%), and 51 died (12.3%). The timing of the VPS procedure and cerebral complications had an effect on the final outcome. Early VPS gave a better outcome in mild and moderate hydrocephalus (p = 0.040). This study has shown that early surgical procedure for mild/moderate hydrocephalus has a positive effect on the morbidity and mortality of hydrocephalus in childhood TBM (p = 0.014, p = 0.040, respectively). In severe hydrocephalus, there was a tendency for early shunting to have a positive effect on morbidity, although this did not reach statistical significance.
