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Role of ventriculoperitoneal shunt in post-tuberculous meningitic hydrocephalous
Abstract:
Thirty-two patients with post-tuberculous meningitic hydrocephalous were admitted. Thirty were subjected to ventriculoperitoneal shunt. Diagnosis was based on CSF analysis and CT scan. Five patients at a Glasgow Coma Score of 3-7 underwent an external ventricular drainage as an initial procedure followed by shunt in 3 patients when condition improved, 17 patients who were conscious at the time of admission made good recovery as compared to 13 patients with altered consciousness who either died (5 patients), or were disabled (8 patients) even after surgery. A mortality of 22% was noted. An early detection and referral is desired to improve the prognosis.
Insights
Early detection and referral for post-tuberculous meningitic hydrocephalus improve patient outcomes. Surgical intervention, like ventriculoperitoneal shunts, shows better results in conscious patients, highlighting the need for timely diagnosis and treatment.
Area of Science:
- Neurology
- Neurosurgery
- Infectious Diseases
Background:
- Post-tuberculous meningitic hydrocephalus is a serious complication of tuberculous meningitis.
- Hydrocephalus can lead to significant neurological deficits and mortality if untreated.
Purpose of the Study:
- To evaluate the outcomes of surgical management for post-tuberculous meningitic hydrocephalus.
- To identify factors influencing prognosis in these patients.
Main Methods:
- Retrospective analysis of 32 patients with post-tuberculous meningitic hydrocephalus.
- Diagnosis confirmed by cerebrospinal fluid (CSF) analysis and CT scans.
- Surgical interventions included ventriculoperitoneal shunts and external ventricular drainage.
Main Results:
- 30 patients underwent ventriculoperitoneal shunting; 5 with severe neurological impairment initially received external ventricular drainage.
- Conscious patients at admission had significantly better recovery rates compared to those with altered consciousness.
- Mortality rate was 22%, with 8 patients experiencing disability despite surgical intervention.
Conclusions:
- Ventriculoperitoneal shunting is an effective treatment for post-tuberculous meningitic hydrocephalus.
- Patient consciousness level at admission is a critical prognostic factor.
- Early detection and prompt referral are crucial for improving outcomes and reducing mortality.