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| Year : 2009 | Volume
: 57
| Issue : 5 | Page : 691 |
Management of hydrocephalus in patients with tuberculous meningitis
YR Yadav, Vijay Parihar
Neuro Surgery Unit, NSCB Medical College Jabalpur, MP - 482 003, India
| Date of Acceptance | 06-Oct-2009 |
| Date of Web Publication | 20-Nov-2009 |
Correspondence Address:
Y R Yadav
Neuro Surgery Unit, NSCB Medical College Jabalpur, MP - 482 003
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0028-3886.57783
How to cite this article:
Yadav Y R, Parihar V. Management of hydrocephalus in patients with tuberculous meningitis. Neurol India 2009;57:691 |
To the Editor: We read Prof. Rajshekhar's article [1] with interest. It is a very well written and quite informative. He has rightly mentioned that hydrocephalus is very common in tubercular meningitis (TBM). We have few comments regarding types of hydrocephalus and modes of treatments. Author has mentioned only two types of hydrocephalus (Obstructive and Communicating), while hydrocephalus in TBM could be purely obstructive, purely communicating or due to combinations of pathologies (obstruction in addition to defective absorption). [2],[3] Patients with combination of pathologies (complex hydrocephalus) could result in failure of ETV in spite of a patent stoma. Author has also mentioned that the success rate of endoscopic third ventriculostomy (ETV) in TBM is low. This is because of high incidence (28%) of complex hydrocephalus in this group. [2] Lumbar peritoneal (LP) shunt is effective in failed ETV cases in TBM hydrocephalus where stoma is patent. [2] Communicating hydrocephalus is more common than obstructive hydrocephalus or hydrocephalus due to combination of pathologies. Author has also agreed that communicating hydrocephalus is more common in TBM, while he has not mentioned lumbar peritoneal shunt as a treatment option at all. Lumbar peritoneal shunt is a better alternative in communicating hydrocephalus than ventriculo-peritoneal shunt. [4],[5] Lumbar peritoneal shunt has the advantage of being an entirely extracranial operation.
| » References | |  |
| 1. | Rajshekhar V. Management of hydrocephalus in patients with tuberculous meningitis. Neurol India 2009;57:368-74.  [PUBMED]  |
| 2. | Yadav YR, Mukerji G, Parihar V, Sinha M, Pandey S. Complex hydrocephalus: a0 n important cause of failed endoscopic third ventriculostomy. BMC Res Notes 2009;2:137. [PUBMED] [FULLTEXT] |
| 3. | Beni-Adani L, Biani N, Ben-Sirah L, Constantini S. The occurrence of obstructive vs absorptive hydrocephalus in newborns and infants: r0 elevance to treatment choices. Childs Nerv Syst 2006;22:1543-63. [PUBMED] [FULLTEXT] |
| 4. | Yadav YR, Pande S, Raina VK, Singh M. Lumboperitoneal shunts: r0 eview of 409 cases. Neurol India 2004;52:188-90. [PUBMED] |
| 5. | Aoki N. Lumboperitoneal shunt: clinical applications, complications, and comparison with ventriculoperitoneal shunt. Neurosurgery 1990;26:998-1003. [PUBMED] [FULLTEXT] |
| This article has been cited by | | 1 |
Clinical course, complications and predictors of mortality in patients with tuberculous meningitis - an experience of fifty two cases at Civil Hospital Karachi, Pakistan |
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| Salekeen, S. and Mahmood, K. and Naqvi, I.H. and Baig, M.Y. and Akhter, S.T. and Abbasi, A. | | Journal of the Pakistan Medical Association. 2013; 63(5): 563-567 | | [Pubmed] | | | 2 |
Ostomy closure and the role of repeat endoscopic third ventriculostomy (re-ETV) in failed ETV procedures |
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| Mahapatra, A. and Mehr, S. and Singh, D. and Tandon, M. and Ganjoo, P. and Singh, H. | | Neurology India. 2011; 59(6): 867-873 | | [Pubmed] | | | 3 |
Modified External Ventricular Drainage in Pediatric Tuberculous Meningitis: Is It Possible to Avoid Ventriculoperitoneal Shunt Placement? |
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| Jian Lin,Nu Zhang,Hang-song Sheng,Mao-de Wang,Bo Yin,Fen-chun Lin | | Pediatric Neurosurgery. 2011; 47(2): 108 | | [Pubmed] | [DOI] | | | 4 |
Modified external ventricular drainage in pediatric tuberculous meningitis: Is it possible to avoid ventriculoperitoneal shunt placement? |
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| Lin, J., Zhang, N., Sheng, H.-S., Wang, M.-D., Yin, B., Lin, F.-C. | | Pediatric Neurosurgery. 2011; 47(2): 108-112 | | [Pubmed] | |
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