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Intracranial hypertension causing visual failure in cryptococcus meningitis.

C T Tan1

  • 1Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Journal of Neurology, Neurosurgery, and Psychiatry
|July 1, 1988
PubMed
Summary
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Cryptococcal meningitis can cause vision loss due to increased intracranial pressure. Aggressive treatment, including shunting for intracranial hypertension, significantly improves vision in affected patients.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Ophthalmology

Background:

  • Cryptococcal meningitis is a serious fungal infection affecting the central nervous system.
  • Papilloedema and visual impairment are known complications.
  • The management of increased intracranial pressure in this context requires further elucidation.

Purpose of the Study:

  • To review outcomes of patients with cryptococcal meningitis and visual complications.
  • To evaluate the effectiveness of aggressive management for intracranial hypertension.

Main Methods:

  • Retrospective review of 34 patients with cryptococcal meningitis.
  • Analysis of patients with papilloedema and visual impairment.
  • Assessment of outcomes following interventions for intracranial hypertension, including shunting.

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Main Results:

  • Eleven patients with bilateral papilloedema and visual impairment survived.
  • Seven patients underwent aggressive management, including shunting.
  • These patients showed substantial improvement in vision.

Conclusions:

  • Papilloedema and visual failure in cryptococcal meningitis indicate raised intracranial pressure.
  • Vigorous treatment of intracranial hypertension is crucial for visual recovery.
  • Shunting can be an effective intervention for managing intracranial hypertension in these cases.