OUTCOMES OF VENTRICULOPERITONEAL SHUNT SURGERY FOR TUBERCULOUS HYDROCEPHALUS AT THE National Lung Hospital, 2021 - 2025
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Abstract
Objective: To evaluate the outcomes of ventriculoperitoneal shunt (VPS) surgery and associated factors in patients with tuberculous hydrocephalus treated at the National Lung Hospital from 2021 to 2025.
Subjects and methods: This retrospective descriptive study included 45 patients with tuberculous hydrocephalus who underwent VPS surgery. Treatment outcomes were assessed based on clinical improvement, neuroimaging findings, and the Glasgow Outcome Scale (GOS) at 1 and 6 months after surgery.
Results: The mean age was 38.4 ± 18.1 years, and males accounted for 60.0% of cases. Most patients presented with advanced disease, with Vellore grades III–IV accounting for 84.4% and BMRC stages II–III for 86.7%. Communicating hydrocephalus was observed in 97.8% of patients. At 1 month after surgery, good outcomes (GOS 4–5) were achieved in 68.9% of patients; at 6 months, this rate was 62.2%. The cumulative 6-month mortality rate was 33.3%. The main complications were shunt obstruction (13.3%) and shunt infection (2.2%). Factors associated with poor outcomes included age ≥60 years, low Glasgow Coma Scale score, Vellore grade IV, BMRC stage III, hyponatremia, elevated cerebrospinal fluid ADA levels, and cerebral infarction.
Conclusion: VPS surgery effectively improves symptoms of increased intracranial pressure and ventricular dilatation in patients with tuberculous hydrocephalus. However, prognosis remains largely dependent on preoperative clinical severity and parenchymal brain injury.
Keywords
Tuberculous meningitis, tuberculous hydrocephalus, ventriculoperitoneal shunt, VP shunt
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References
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