[Role of modified external ventricular drainage in the management of children with tuberculous meningitis hydrocephalus].
OBJECTIVE
To explore the role of modified external ventricular drainage (mEVD) in the treatment of tuberculous meningitis obstructive hydrocephalus in children.


METHODS
The records were retrospectively reviewed for 30 pediatric patients of tuberculous meningitis with hydrocephalus (TBMH) undergoing surgery between January 2007 and December 2010. The procedures included ventricular abdomen subcutaneous drainage (mEVD) (n = 6), Ommaya reservoir (n = 9) and ventriculoperitoneal shunt (VPS) (n = 15). White cell count and protein content of cerebrospinal fluid were measured repeatedly. And their clinical outcomes were assessed at 6 months post-operation.


RESULTS
External drainage was extracted for 4 of 6 TBMH patients after 4 - 6 months of mEVD. Neither intracranial infections nor serious postoperative complications occurred. Two of 6 TBMH received VPS substituting for mEVD. No statistically significant difference in white cell count, protein content of cerebrospinal fluid and outcome was found between the mEVD and VPS groups.


CONCLUSIONS
Ventricular abdomen subcutaneous drainage is both safe and efficacious in the management of children with tuberculous meningitis hydrocephalus. This approach may avoid possible complications and long-term indwelling shunt so that it is worthy of further clinical application.
Department of Neurosurgery, First Affiliated Hospital, Medical College of Xi'an Jiaotong University, Xi'an 710061, China.
Jian
J
Lin
Nu
N
Zhang
Han-Song
HS
Sheng
Bo
B
Yin
Huai-Ou
HO
Wang
Mao-de
MD
Wang
D002648:Child; D004322:Drainage; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D012189:Retrospective Studies; D014390:Tuberculosis, Meningeal; D017287:Ventriculoperitoneal Shunt