INTRODUCTION: Treatment of obstructive hydrocephalus in children with tuberculous meningitis (TBM) depends on the level of the cerebrospinal fluid (CSF) block. Air-encephalography is regarded as the gold standard for differentiating communicating and non-communicating hydrocephalus. Since air-encephalography involves a lumbar puncture, it carries the risk of cerebral herniation. AIM. The aim of this study was to determine whether communicating and non-communicating hydrocephalus in TBM can be differentiated by means of cranial computerised tomography (CT). METHODS: A number of CT indices were measured in 50 children with communicating and 34 children with non-communicating hydrocephalus according to air-encephalographic findings. RESULTS: The only CT finding that correlated with the type of hydrocephalus was the shape of the third ventricle. Significantly more children with non-communicating hydrocephalus had a rounded third ventricle than those with communicating hydrocephalus. CONCLUSION: CT is therefore not useful in determining the level of CSF block in TBM. Air-encephalography remains the most reliable way of determining the level of CSF obstruction.
INTRODUCTION: Treatment of obstructive hydrocephalus in children with tuberculous meningitis (TBM) depends on the level of the cerebrospinal fluid (CSF) block. Air-encephalography is regarded as the gold standard for differentiating communicating and non-communicating hydrocephalus. Since air-encephalography involves a lumbar puncture, it carries the risk of cerebral herniation. AIM. The aim of this study was to determine whether communicating and non-communicating hydrocephalus in TBM can be differentiated by means of cranial computerised tomography (CT). METHODS: A number of CT indices were measured in 50 children with communicating and 34 children with non-communicating hydrocephalus according to air-encephalographic findings. RESULTS: The only CT finding that correlated with the type of hydrocephalus was the shape of the third ventricle. Significantly more children with non-communicating hydrocephalus had a rounded third ventricle than those with communicating hydrocephalus. CONCLUSION: CT is therefore not useful in determining the level of CSF block in TBM. Air-encephalography remains the most reliable way of determining the level of CSF obstruction.
Authors: Chandrashekhar E Deopujari; Llewelyn Padayachy; Alias Azmi; Anthony Figaji; Saurav K Samantray Journal: Childs Nerv Syst Date: 2018-08-11 Impact factor: 1.475
Authors: Ben J Marais; Anna D Heemskerk; Suzaan S Marais; Reinout van Crevel; Ursula Rohlwink; Maxine Caws; Graeme Meintjes; Usha K Misra; Nguyen T H Mai; Rovina Ruslami; James A Seddon; Regan Solomons; Ronald van Toorn; Anthony Figaji; Helen McIlleron; Robert Aarnoutse; Johan F Schoeman; Robert J Wilkinson; Guy E Thwaites Journal: Clin Infect Dis Date: 2017-02-15 Impact factor: 9.079