Clinical analysis of ventriculoperitoneal shunt for grade Ⅳ tuberculous meningitis children with hydrocephalus / 中华实用儿科临床杂志

ABSTRACT

Objective To explore the effects of ventriculoperitoneal shunt(VPS) placement in those children with grade Ⅳ tuberculous meningitis with hydrocephalus (TBMH) clinical analysis.Methods Nine cases of grade Ⅳ TBMH who received VPS from Jan.2006 to Dec.2009 were retrospectively reviewed,including age,gender,disease development,clinical manifestations,laboratory data,treatment,prognosis and complications.All children received VPS placement combined with pharmacal treatment.External ventricular drainage(EVD) were given only 2 cases with severe biochemical derangements or brainstem dysfunction requiring correction before shunt surgery.Outcomes were divided into normal,mild sequelae,severe sequelae,death or vegetable status.Results The average follow-up period was 15 months.Two patients had a full recovery,3 patients had slight sequelae,2 patients had severe sequela,and another 2 patients expired.Four cases complications related to the shunt surgery were seen,1 patient had shunt block,2 patients had infections and 1 patient had subdural effusion and ventricular hemorrhage.Conclusions Directly VPS surgery can improve the outcome of grade Ⅳ TBMH.The response of EVD is not a reliable indication for selecting patients who would benefit from shunt surgery.