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Can CT predict the level of CSF block in tuberculous hydrocephalus?

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Abstract

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.

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References

  1. Bharucha PE, Iyer CGS, Bharucha EP, Deshpande DH (1969) Tuberculous meningitis in children: a clinicopathological evaluation of 24 cases. Indian Pediatr 6:282–295

    CAS  PubMed  Google Scholar 

  2. Donald PR, Cotton MF, Hendricks MK (1996) Pediatric meningitis in the Western Cape Province of South Africa. J Trop Pediatr 42:256–261

    CAS  PubMed  Google Scholar 

  3. Lamprecht D, Schoeman JF, Donald P, Hartzenberg H (2001) Ventriculo peritoneal shunting in childhood tuberculous meningitis. Br J Neurosurg 15:119–125

    Article  CAS  PubMed  Google Scholar 

  4. Liechty EA, Gilmor RL, Bryson CQ, Bull MJ (1983) Outcome of high risk neonates with ventriculomegaly. Dev Med Child Neurol 25:162–168

    CAS  PubMed  Google Scholar 

  5. Lorber J (1951) Studies of the cerebrospinal fluid circulations in tuberculous meningitis in children. II. A review of 100 pneumo-encephalograms. Arch Dis Child 26:28–44

    Google Scholar 

  6. Naidich TP, Schott LH, Baron RL (1982) Computed tomography in evaluation of hydrocephalus. Radiol Clin North Am 20:143–167

    CAS  PubMed  Google Scholar 

  7. Schoeman JF (1987) The role of continuous intracranial pressure monitoring in the management of children with tuberculous meningitis. Doctoral thesis, University of Stellenbosch

  8. Schoeman JF, Le Roux D, Bezuidenhout PB, Donald PR (1985) Intracranial pressure monitoring in tuberculous meningitis: clinical and computerized tomographic correlation. Dev Med Child Neurol 27:644–654

    CAS  PubMed  Google Scholar 

  9. Schoeman JF, Hewlett RH, Donald PR (1988) MR of childhood tuberculous meningitis. Neuroradiology 30:473–477

    CAS  PubMed  Google Scholar 

  10. Schoeman JF, Donald PR, Van Zyl L, Keet MP, Waite J (1991) Tuberculous hydrocephalus: comparison of different treatments with regard to ICP, ventricular size and clinical outcome. Dev Med Child Neurol 33:396–405

    CAS  PubMed  Google Scholar 

  11. Schoeman JF, Van Zyl LE, Laubscher JA, Donald PR (1995) Serial CT scanning in childhood tuberculous meningitis: prognostic features in 198 cases. J Child Neurol 10:320–329

    Google Scholar 

  12. Schoeman JF, Laubscher JA, Donald PR (2000) Serial lumbar CSF pressure measurements and cranial computed tomographic findings in childhood tuberculous meningitis. Childs Nerv Syst 16:203–209

    Article  CAS  PubMed  Google Scholar 

  13. Visudhiphan P, Chiemchanya S (1979) Hydrocephalus in tuberculous meningitis in children: treatment with acetazolamide and repeated lumbar puncture. J Pediatr 95:657–660

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Paediatrics and Child Health, Faculty of Health Sciences, Tygerberg Hospital, PO Box 19063, 7505, Tygerberg, South Africa

    G. E. Bruwer & J. F. Schoeman

  2. Department of Radiology, Tygerberg Hospital, PO Box 19063, 7505, Tygerberg, South Africa

    S. Van der Westhuizen

  3. Biostatistics Unit, Medical Research Council, Tygerberg, South Africa

    C. J. Lombard

Authors
  1. G. E. Bruwer
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  2. S. Van der Westhuizen
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  3. C. J. Lombard
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  4. J. F. Schoeman
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Corresponding author

Correspondence to J. F. Schoeman.

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Bruwer, G.E., Van der Westhuizen, S., Lombard, C.J. et al. Can CT predict the level of CSF block in tuberculous hydrocephalus?. Childs Nerv Syst 20, 183–187 (2004). https://doi.org/10.1007/s00381-003-0887-x

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  • DOI: https://doi.org/10.1007/s00381-003-0887-x

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