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Viral Meningitis

Viral Meningitis

Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...

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Updated: Mar 31, 2026

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus

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Shunting in cryptococcal meningitis.

Jacob Cherian¹, Robert L Atmar², Shankar P Gopinath¹

¹Departments of 1 Neurosurgery and.

Journal of Neurosurgery

|October 31, 2015

Summary

This summary is machine-generated.

For cryptococcal meningitis patients with intracranial hypertension, serial lumbar punctures are often effective. However, shunting procedures may be necessary for persistent cases, particularly in women and those with rising cryptococcal antigen levels.

Keywords:

HAART = highly active antiretroviral therapy IRIS = immune reconstitution inflammatory syndrome cryptococcal meningitis headache infection lumbar puncture shunt

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Area of Science:

Neuroscience
Infectious Diseases
Neurosurgery

Background:

Cryptococcal meningitis frequently causes symptomatic intracranial hypertension.
The necessity of permanent cerebrospinal fluid (CSF) diversion for managing this complication is not well-established.

Purpose of the Study:

To evaluate the role and outcomes of CSF diversion in patients with cryptococcal meningitis and intracranial hypertension.
To identify factors associated with the need for shunting procedures.

Main Methods:

A retrospective review of 50 cryptococcal meningitis cases over five years at a single teaching hospital.
Data collection included ICD-9 codes, operative logs, and laboratory records.
Analysis focused on intracranial pressure, lumbar punctures, and shunting procedures.

Main Results:

Ninety-eight percent of identified patients were HIV-positive.
Elevated opening pressure was common, with 38/50 patients developing it over time.
Thirteen patients underwent shunting, with female sex and increasing CSF cryptococcal antigen significantly associated with this need.

Conclusions:

CSF diversion, particularly ventriculoperitoneal shunting, can provide sustained relief for intracranial hypertension in cryptococcal meningitis.
Serial lumbar punctures are often sufficient, but shunting is a viable option for refractory cases.
This study represents a significant series on shunting for HIV-positive patients with this condition.