Neurosurgical aspects of cerebral cryptococcosis.
Eleven patients with raised intracranial pressure caused by cerebral cryptococcosis developed complications requiring neurosurgical operations. Two patients were fully conscious on admission, and 9 had impaired consciousness, four of whom were comatose. Seven patients were found to have hydrocephalus only. Two patients had cerebral edema initially, and 2 had cystic lesions. One of the latter developed subdural effusion. All patients eventually developed progressive hydrocephalus requiring placement of a ventriculoperitoneal shunt. Four patients were initially treated by external ventricular drainage. When external ventricular drainage was used initially, there were no associated complications; however, there was a high incidence of complications (4 of 7 patients) when a ventriculoperitoneal shunt was placed as the initial treatment. Of the 11 patients, 10 (91%) survived; of these 9 (82%) made an excellent recovery and 7 (64%) returned to their original work. The patient who died had been receiving steroid therapy for hypopituitarism.
Department of Surgery, University of Hong Kong, Queen Mary Hospital.
K H
KH
Chan
K S
KS
Mann
C P
CP
Yue
D000293:Adolescent; D000328:Adult; D001927:Brain Diseases / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D002648:Child; D003453:Cryptococcosis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery / Q000379:methods; D014057:Tomography, X-Ray Computed