Frequency of Hydrocephalus in Cases of Tuberculous Meningitis

Abstract

Aim: To determine the frequency of hydrocephalus in cases of Tuberculous meningitis Methods: This was a cross sectional study conducted during 01-07-16 to 31-12-2017 at Department of Medicine, Sheikh Zayed Hospital, Rahim Yar Khan. The cases of tuberculosis meningitis of age range of 15 to 50 years of either gender with tuberculous meningitis were included in this study. The diagnosis of TBM was made on the basis of combination of clinical symptoms and laboratory data. The symptoms were fever, weight loss and neck rigidity with or without fits. These cases then underwent CSF analysis under aseptic measures. The findings to label TBM on CSF were low glucose (< 40 mg/dl), increased protein content (> 100 mg/dl) and high WBC count with predominance of lymphocytes. The cases of TBM were divided according to standard BMRC scale into three stages. The cases with bacterial meningitis, having any SOL in brain and those with any previous history of neurosurgery were excluded from this study. Then these cases underwent CT brain in the same institute and diagnosis of Hydrocephalus was made when any of the ventricle is dilated more than 25% of the baseline. Results: In this study there were total 93 cases of TBM with mean age of 37.11±08.67years. There were 54(58.06%) males and 39(41.94%) females. Maximum cases were seen in stage II of TBM which affected 65 (69.89%) cases. Hydrocephalus was seen in 61(65.59%) of the cases as shown in figure 01. Hydrocephalus was significantly high in male gender as compared to females where it affected 39(72.22%) of cases with p value of 0.03. It was also more common in cases that had age group 15-29 years affecting 40(67.79%) of cases with p= 0.86. Hydrocephalus was also significantly high in cases with stage II and III of TB affecting 66.15% and 77.27% of cases respectively with p= 0.01. Conclusion: Hydrocephalus is very common in cases of TBM and it is significantly high in male gender and stage II and III of TBM. Key words: TBM, Hydrocephalus