Postmeningitic hydrocephalus

We have treated 23 patients with postmeningitic hydrocephalus during the past 20 years; 13 males and 10 females, ranging in age from 1 day to 6 years (mean 300 days). The outcome was good in 6 patients, fair in 5, moderately good in 5 and poor in 7. Ventricular size on CT scan was analyzed pre- and postoperatively by Evans' Index. Postmenigitic hydrocephalus was classified into 3 types; S-S type (slow onset-slow response), R-R type (rapid onset-rapid response), and N-R type (no response). In the S-S type, it took several months for the ventricle to increase and decrease in size, while in the R-R type, it took a few weeks. Patients with the S-S type had almost normal mental status and in those with the R-R type, mental status was mildly deteriorated. In the N-R type patients, ventricular size did not decrease after V-P shunt. These findings suggest that the choice of therapeutic options for patients with postmeningitic hydrocephalus should be based on the chronological changes after onset. In S-S type patients, correct diagnosis and optimal treatment are important for obtaining a good outcome. (author)