乳幼児髄膜炎後水頭症に対する外科的治療法の検討

抄録

Fourteen cases of infantile hydrocephalus resulting from purulent meningitis were presented, out of which five cases were associated with lumbosacral meningccele. There have been many problems for the surgical treatments of postmeningitic hydrocephalus, which is quite different from those of congenital hydrocephalus, because of the presence of infection and increased protein content in the cerebrospinal fluid. It is also one of the most important factors to determine the period of the surgical procedure. In our clinic, the following prccedure is carried out for the treatment of postmeningitic hydrocephalus. The first: ventricular tap or drain age is performed at situations which culture of the CSF is positive and hydrocephalus is progessive. In addition, antibiotic therapy is maintained as long as persistent fever or evidence of cellular reaction in the CSF remains. The second: ventriculo-peritoneal shunt should be performed after the culture of the CSF was negative for more than three weeks and total protein content in the CSF dropped down to less than 500mg/dl. The third: if v-p shunt is ineffective for reducing increased intracranial pressure, it should be replaced to the ventriculo-atrial shunt.