Post-infective hydrocephalus

Abstract

Hydrocephalus which occurs after pyogenic or chronic infections of the brain is called "postinfective" hydrocephalus. Escherichia coli, group B streptococci, and Haemophilus and Neisseria meningitidis may be the causative organisms responsible for pyogenic meningitis in different age groups, and hydrocephalus follows the development of inflammatory exudates in the basal cisterns. In post-tubercular hydrocephalus, it is the fibrosis in the healing stage that is responsible for occlusion of the arachnoid villi and cerebrospinal fluid pathways. Hydrocephalus can also occur after prenatal infections like after toxoplasmosis or cytomegalovirus infections. Rarely hydrocephalus may occur after mycotic or viral infections of the brain. Whereas in postinfective hydrocephalus, the CSF is rendered sterile while a temporizing procedure like a ventriculo-subgaleal shunt may be performed, in the post-tubercular hydrocephalus, it is necessary to ascertain the level of intraventricular pressure before deciding on a diversion procedure, either by an endoscopic third ventriculostomy or a ventriculoperitoneal shunt.