Clinical Pattern and Post-Operative Complications of Post Tuberculous Meningitis Hydrocephalus in Patients Underwent Ventriculoperitoneal Shunt

Abstract

Objective: To determine the clinical presentation of post tuberculous meningitis hydrocephalus and post-operative complications in patients underwent placement of a ventriculoperitoneal shunt.
Study Design: This Quasi-experimental study was conducted at Department of Neurosurgery of Dow University of Health Sciences/ Civil Hospital, Karachi. Study duration was six months from October 2013 to March 2014.
Methodology: Total 40 patients were studied who were diagnosed as cases of tuberculous meningitis and hydrocephalus on the basis of history, clinical examination, CSF findings, CT and MRI. Each patient underwent placement of a ventriculoperitoneal shunt. All the data regarding clinical presentation and postoperative complications was recorded in the proforma
RESULTS: Total 40 patients having tuberculous meningitis hydrocephalus were selected; their mean age was 16.4+07.8 years. Male were found in the majority 62.50%, as compared to female 37.50%. According to the clinical presentation, most patients 70.0% were presented with a headache and 62.50% with fever, followed by nausea and vomiting was in 37.5% patients, Neck rigidity was in 27.50% cases, extra neural tuberculosis in 25.0% patients, papilledema in 22.50% cases, limb weakness in 10.0% patients, while fits were found only in 5.0% of the patients. Past history of tuberculosis was in 7.50% patients. According to postoperative complications infection was found in 10.0% of the cases, peritoneal pseudo-cyst without infection was in 7.5% cases, while 10.0% patients died. No significant difference was found in the postoperative complications according to gender p-value 0.94.
Conclusion: It is concluded that a headache, fever and nausea/vomiting were the commonest clinical features and the Ventriculoperitoneal shunt is relatively simple and suitable for the patients of all age groups with hydrocephalus, its complications are relatively easy to manage.