Use of intrathecal hyaluronidase in the management of tuberculous meningitis with hydrocephalus

Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery
S N Bhagwati, K George

Abstract

A preliminary study to evaluate the efficacy of intrathecal hyaluronidase was carried out in nine children suffering from tuberculous meningitis with communicating hydrocephalus. This was followed by a randomized trial in which five cases were treated with intrathecal hyaluronidase, while six cases were treated by the insertion of a ventriculoperitoneal shunt. No untoward reaction of any significance was noted. The results were judged in terms of improvement in the sensorium and mentation, in specific neurological deficit (e.g., visual impairment and hemiparesis), and in overall functional performance. Although most of the patients receiving hyaluronidase showed some improvement in the sensorium, only one of the nine preliminary cases and one of the five cases in the randomized trial showed a total recovery of function. Two of the six shunted patients, however, showed complete recovery. Shunt insertion led to further improvement in two of the nine preliminary cases who had failed to respond to treatment with hyaluronidase. This preliminary study shows that intrathecal hyaluronidase does, in most cases, lead to an improvement in the sensorium but does not offer any particular advantage over shunt insertion in terms of regression...Continue Reading

References

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Citations

Sep 20, 2011·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Vivek Tandon, Ashok Kumar Mahapatra
Mar 6, 2015·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Chandrashekhar Eknath Deopujari
Jul 7, 2018·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Dattatraya MuzumdarDeopujari Chandrashekhar
Feb 6, 2016·Fluids and Barriers of the CNS·Marc R Del Bigio, Domenico L Di Curzio
Sep 2, 2016·The Cochrane Database of Systematic Reviews·Sophie JullienRohit Bhatia

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