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Serial lumbar CSF pressure measurements and cranial computed tomographic findings in childhood tuberculous meningitis

dc.contributor.authorSchoeman J.F.
dc.contributor.authorLaubscher J.A.
dc.contributor.authorDonald P.R.
dc.date.accessioned2011-05-15T16:16:02Z
dc.date.available2011-05-15T16:16:02Z
dc.date.issued2000
dc.identifier.citationChild's Nervous System
dc.identifier.citation16
dc.identifier.citation4
dc.identifier.issn02567040
dc.identifier.urihttp://hdl.handle.net/10019.1/13605
dc.description.abstractIntracranial pressure (ICP) was monitored in 218 consecutive children with hydrocephalus secondary to tuberculous meningitis (TBM). All children underwent cranial computerized tomographic (CT) scanning and continuous lumbar cerebrospinal (CSF) pressure monitoring on admission. Noncommunicating hydrocephalus (37 children), as determined by air encephalography, was treated by ventriculoperitoneal (VP) shunting and communicating hydrocephalus (181 children), by means of daily acetazolamide and frusemide. Response of ICP to treatment in the group with communicating hydrocephalus was assessed by means of repeated CSF pressure monitoring and CT scanning. One hundred and eighty-five of the 218 patients survived the 1st month of treatment. The aim of this study was the retrospective determination of (1) the relationship between ICP measurements and CT findings on admission and (2) the characteristics of the ICP recording which correlated best with the CT criteria of compensated hydrocephalus after the 1st month of treatment. No relationship was found between the level of baseline CSF pressure and the degree of hydrocephalus, as demonstrated by CT scanning, on admission. Seventy-five per cent of the patients with communicating hydrocephalus that survived the 1st month of treatment complied with the CT criteria for compensated hydrocephalus. All these patients had a baseline CSF pressure below 15 mmHg and absence of high-amplitude B waves on the pressure recording done at the end of the 1st month. In this study repeated lumbar CSF pressure monitoring proved to be an effective instrument to assess the response of communicating tuberculous hydrocephalus to medical treatment and also accurately predicted the timing of compensation of the hydrocephalus.
dc.subjectacetazolamide
dc.subjectethionamide
dc.subjectfurosemide
dc.subjectisoniazid
dc.subjectprednisone
dc.subjectpyrazinamide
dc.subjectrifampicin
dc.subjecttuberculostatic agent
dc.subjectarticle
dc.subjectbrain radiography
dc.subjectbrain ventricle peritoneum shunt
dc.subjectcerebrospinal fluid pressure
dc.subjectchild
dc.subjectcommunicating hydrocephalus
dc.subjectcomputer assisted tomography
dc.subjectdiagnostic value
dc.subjecthuman
dc.subjecthydrocephalus
dc.subjectintracranial hypertension
dc.subjectintracranial pressure
dc.subjectmajor clinical study
dc.subjectMycobacterium tuberculosis
dc.subjectpneumoencephalography
dc.subjectpriority journal
dc.subjecttreatment outcome
dc.subjecttuberculous meningitis
dc.subjectAcetazolamide
dc.subjectAntitubercular Agents
dc.subjectCerebrospinal Fluid Pressure
dc.subjectChild
dc.subjectCombined Modality Therapy
dc.subjectDrug Therapy, Combination
dc.subjectFurosemide
dc.subjectHumans
dc.subjectHydrocephalus
dc.subjectIntracranial Pressure
dc.subjectPrednisone
dc.subjectProspective Studies
dc.subjectRetrospective Studies
dc.subjectSurvival Rate
dc.subjectTomography, X-Ray Computed
dc.subjectTuberculosis, Meningeal
dc.subjectVentriculoperitoneal Shunt
dc.titleSerial lumbar CSF pressure measurements and cranial computed tomographic findings in childhood tuberculous meningitis
dc.typeArticle
dc.description.versionArticle


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