Outcome of Post Tuberculous Meningitic Hydrocephalus Following Neurosurgical Intervention

Objective: To find out the outcome in terms of mortality in adult patients with post tuberculous meningitic hydrocephalus after neurosurgical intervention. Design: Descriptive study. Place and Duration of Study: It was a one year study from April 2007 up to May 2008, conducted in the Department of Neurosurgery, Jinnah Post graduate Medical Centre, Karachi. Patients and Methods: A total of 42 patients with tuberculous meningitis and hydrocephalus were included in the study. Data collection was done with the help of a proforma including the clinical features, Glasgow coma score (GCS), CT scan findings, surgical intervention and post operative outcome. The patients were divided into two groups as group I with GCS 9-15 and group II with GCS 3-8. Results: There were total 42 patients with age range from 15 to 60 years. In group I we had 29 patients and in group II there were 13 patients. In group I ventriculoperitoneal (VP) shunt was inserted in 27 patients and external ventricular drain (EVD) was inserted in two patients while in group II VP shunt was inserted in 2 patients while EVD was inserted in 11 patients. Follow up was done for 3 months; all of the patients were put on anti tuberculous treatment (ATT). In group I there were 2 mortalities while in group II, six patients expired. So the overall mortality was 19%. Conclusion: The outcome of Neurosurgical intervention in patients with post tuberculous meningitic hydrocephalus depends upon the clinical condition and GCS of the patient. In good GCS, early intervention has better results and lower mortality