Ventriculoatrial shunting for hydrocephalus complicating tuberculous meningitis

Relatively little attention has been focused on the management of increased intracranial pressure which develops in patients with tuberculous meningitis. In the acute phase of infection, cerebral edema is the most common cause; whereas in the subacute or chronic phases, hydrocephalus is most often implicated. Patients with tuberculous meningitis may fail to show neurologic improvement or deteriorate despite appropriate medical therapy, no matter what the pathogenesis of increased intracranial pressure. The patient we describe illustrates the usefulness of ventricular shunting in patients with hydrocephalus who fail to respond to the administration of antituberculous and pressure-reducing agents.