Endoscopic third ventriculostomy for chronic hydrocephalus after tuberculous meningitis.
BACKGROUND
Cerebrospinal fluid diversion procedures are indicated in patients with hydrocephalus after tuberculous meningitis (TBM). We present 2 patients with hydrocephalus after TBM who were successfully treated with endoscopic third ventriculostomy (ETV).


METHODS
Two patients had been diagnosed with hydrocephalus after TBM and had undergone ventriculoperitoneal shunt surgery for the same. They presented with multiple episodes of shunt dysfunction. Endoscopic third ventriculostomy was performed (twice for one patient), and the patients were evaluated clinically and radiologically after the procedure.


RESULTS
On long-term clinical follow-up (3 and 2 years, respectively), both patients were asymptomatic after the ETV. The first patient was radiologically evaluated 7 months after the procedure and the second patient 2 years after the procedure. The first patient showed a decrease in ventricular size. The second patient did not show any significant change in the ventricular size.


CONCLUSIONS
Endoscopic third ventriculostomy can be considered as a safe and long-lasting solution for hydrocephalus after chronic TBM.
Jonathan
Ashish
A
Department of Neurological Sciences, Christian Medical College and Hospital, Vellore 632004, Tamil Nadu, India.
Rajshekhar
Vedantam
V
D000328:Adult; D002908:Chronic Disease; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D020542:Third Ventricle / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014390:Tuberculosis, Meningeal / Q000150:complications*; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects; D014696:Ventriculostomy / Q000295:instrumentation / Q000379:methods*