Tuberculous meningitis and hydrocephalus treated successfully with a combination of immunomodulation and cerebrospinal fluid diversion

ABSTRACT

The management of tuberculous meningitis with hydrocephalus is complex with most centres advocating ventriculoperitoneal shunting only in the presence of raised CSF pressure. This article reports a case of tuberculous meningitis with hydrocephalus treated with a combination of early surgical and immunomodulatory therapy in addition to conventional steroids and antituberculous agents. This case demonstrates that during the early phase of tuberculous meningitis with hydrocephalus, a combined multi-disciplinary approach will help prevent neuronal injury due to progressive ventricular enlargement and inflammation