Frequency of Hydrocephalus in Patients with Chronic Meningitis due to Mycobacterium Tuberculosis

Abstract

Background: Tuberculosis is one of the causes of chronic meningitis which may lead to hydrocephalus. Uncertainty and doubtdominate all aspects of tuberculous meningitis.Objectives: To determine the frequency of hydrocephalus in tuberculous meningitis patients.Material & Methods: This was observational descriptive study conducted at department of neurosurgery and neurology ladyreading hospital Peshawar from Jan,2016 to Dec,2018. In this study there were total 93 cases of TBM with 95% confidencelevel,2.2% margin of error according to WHO calculator. Diagnosis was based on clinical features, CSF analysis and CT/MRI brain.Tuberculous meningitis patients of age range 15 to 50 years of either gender were included in this study. All those patients havingSOL in brain and other causes of meningitis were excluded from this study.The symptoms were fever, headache, and weight lossand neck rigidity with or without fits. These cases then underwent CSF analysis under aseptic measures. The findings to label TBMon CSF were low glucose ( 100 mg/dl) and high WBC count with predominance oflymphocytes. The data was analyzed with the help of SPSS version 23.Effect modifiers were stratified and and post stratificationChi-Square test was applied with P-value < 0.05 as significant. The cases of TBM were divided according to standard BMRC scaleinto three stages.Results: In this study there were total 93 cases with mean age of 37.11± 08.67 years. 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. Hydrocephalus was significantly high in male gender as compared to females where it affected 39 (72.22%)of cases. It was also more common in cases that had age group 15-29 years affecting 40 (67.79%) of cases.Conclusion: Hydrocephalus is a common complication of tuberculous meningitis and it is predominantly seen in in male patients,stage II and III of TBM.Keywords: TBM, Hydrocephalus, Meningitis