Skip to main content

Advertisement

SpringerLink
Log in

Effects of the implantation of Ommaya reservoir in children with tuberculous meningitis hydrocephalus: a preliminary study

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Objective

The role of Ommaya reservoir implantation in children with tuberculous meningitis hydrocephalus (TBMH) has been seldomly reported. Therefore, we performed this study to determine the role of the Ommaya reservoir in the treatment of children with TBMH.

Methods

We retrospectively analyzed the effects of Ommaya reservoir implantation in 12 children with TBMH. Intracapsular puncture of the reservoir was performed for draining the cerebrospinal fluid and the TBM was treated by intraventricular injection of isoniazid.

Results

The ideal treatment outcome was observed in nine (75 %) of the 12 children; two (16.7 %) children developed serious disabilities and one of them (8.3 %) eventually died. The treatment method was effective for all six (100 %) children with Palur grade II TBM but showed no effect in three (50 %) children with grade III and IV TBM. The number of leukocytes in the cerebrospinal fluid decreased to 20 × 106/L (75 %) within 2 weeks after implantation of the reservoirs. Finally, the Ommaya reservoirs in eight children were removed but were retained in four children. Four children had to undergo ventriculoperitoneal shunt.

Conclusion

Ommaya reservoir implantation has been shown to be effective in treating children with TBMH. This method may be largely suitable for children with early grade II TBM or partly in children with grade III TBM who have mild or moderate hydrocephalus that can alleviate after short-term treatment. Thus, a good proportion of children who undergo Ommaya reservoir implantation can avoid ventriculoperitoneal shunt surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Camara B, Ly Ba A, Faye PM, Ba A, Ba I, Dia Ndour S, Ba M, Sow HD (2008) Tuberculosis meningitis in a Senegalese pediatric hospital: report of 14 cases. Arch Pediatr 15:322–324

    Article  PubMed  CAS  Google Scholar 

  2. Hosoglu S, Ayaz C, Geyik MF, Kokoglu OF, Ceviz A (1998) Tuberculous meningitis in adults: an eleven-year review. Int J Tuberc Lung Dis 2:553–557

    PubMed  CAS  Google Scholar 

  3. Kemaloglu S, Ozkan U, Bukte Y, Ceviz A, Ozates M (2002) Timing of shunt surgery in childhood tuberculous meningitis with hydrocephalus. Pediatr Neurosurg 37:194–198

    Article  PubMed  Google Scholar 

  4. Misra UK, Kalita J, Roy AK, Mandal SK, Srivastava M (2000) Role of clinical, radiological, and neurophysiological changes in predicting the outcome of tuberculous meningitis: a multivariable analysis. J Neurol Neurosurg Psychiatry 68:300–303

    Article  PubMed  CAS  Google Scholar 

  5. Zumla A, Grange JM (1999) Doing something about tuberculosis. BMJ 318:956

    Article  PubMed  CAS  Google Scholar 

  6. Agrawal D, Gupta A, Mehta VS (2005) Role of shunt surgery in pediatric tubercular meningitis with hydrocephalus. Indian Pediatr 42:245–250

    PubMed  Google Scholar 

  7. Gupta RK, Kathuria MK, Pradhan S (1999) Magnetization transfer MR imaging in CNS tuberculosis. AJNR Am J Neuroradiol 20:867–875

    PubMed  CAS  Google Scholar 

  8. Jiang PF, Yu HM, Zhou BL, Gao F, Shen SX, Xia ZZ, Shui QX (2010) The role of an Ommaya reservoir in the management of children with cryptococcal meningitis. Clin Neurol Neurosur 112:157–159

    Article  Google Scholar 

  9. Yu B, Li SS, Lin ZL, Zhang N (2009) Treatment of posthemorrhagic hydrocephalus in premature infants with subcutaneous reservoir drainage. Pediatr Neurosurg 45:119–125

    Article  PubMed  Google Scholar 

  10. Peretta P, Ragazzi P, Carlino CF, Gaglini P, Cinalli G (2007) The role of Ommaya reservoir and endoscopic third ventriculostomy in the management of post-hemorrhagic hydrocephalus of prematurity. Childs Nerv Syst 23:765–771

    Article  PubMed  Google Scholar 

  11. Jonathan A, Rajshekhar V, Sotelo J, Kao MC (2005) Endoscopic third ventriculostomy for chronic hydrocephalus after tuberculous meningitis. Surgical Neurol 63:32–35

    Article  Google Scholar 

  12. Jha DK, Mishra V, Choudhary A, Khatri P, Tiwari R, Sural A, Kumar S (2007) Factors affecting the outcome of neuroendoscopy in patients with tuberculous meningitis hydrocephalus: a preliminary study. Surg Neurol 68:35–42

    Article  PubMed  Google Scholar 

  13. Chugh A, Husain M, Gupta RK, Ojha BK, Chandra A, Rastogi M (2009) Surgical outcome of tuberculous meningitis hydrocephalus treated by endoscopic third ventriculostomy: prognostic factors and postoperative neuroimaging for functional assessment of ventriculostomy. J Neurosurg Pediatrics 3:371–377

    Article  Google Scholar 

  14. Husain M, Jha DK, Rastogi M, Husain N, Gupta RK (2005) Role of neuroendoscopy in the management of patients with tuberculous meningitis hydrocephalus. Neurosurg Rev 28:278–283

    Article  PubMed  Google Scholar 

  15. Figaji AA, Fieggen AG, Peter JC (2007) Endoscopy for tuberculous hydrocephalus. Childs Nerv Syst 23:79–84

    Article  PubMed  CAS  Google Scholar 

  16. Lin J, Zhang N, Sheng HS, Wang MD, Yin B, Lin FC (2011) Modified external ventricular drainage in pediatric tuberculous meningitis: is it possible to avoid ventriculoperitoneal shunt placement? Pediatr Neurosurg 47:108–112

    Article  PubMed  Google Scholar 

  17. Sandberg DI, Bilsky MH, Souweidane MM, Bzdil J, Gutin PH (2000) Ommaya reservoirs for the treatment of leptomeningeal metastases. Neurosurgery 47:49–55

    PubMed  CAS  Google Scholar 

  18. Joki T, Oi S, Babapour B, Kaito N, Ohashi K, Ebara M, Kato M, Abe T (2002) Neuroendoscopic placement of Ommaya reservoir into a cystic craniopharyngioma. Childs Nerv Syst 18:629–633

    Article  PubMed  Google Scholar 

  19. Al-Anazi A, Bernstein M (2000) Modified stereotactic insertion of the Ommaya reservoir. Technical note. J Neurosurg 92:1050–1052

    Article  PubMed  CAS  Google Scholar 

  20. Dickerman RD, Eisenberg MB (2005) Preassembled method for insertion of Ommaya reservoir. J Surg Oncol 89:36–38

    Article  PubMed  Google Scholar 

  21. Lishner M, Perrin RG, Feld R, Messner HA, Tuffnell PG, Elhakim T, Matlow A, Curtis JE (1990) Complications associated with Ommaya reservoirs in patients with cancer: the Princess Margaret Hospital experience and review of the literature. Arch Intern Med 150:173–176

    Article  PubMed  CAS  Google Scholar 

  22. Figaji AA, Fieggen AG (2010) The neurosurgical and acute care management of tuberculous meningitis: evidence and current practice. Tuberculosis 90:393–400

    Article  PubMed  Google Scholar 

  23. Lamprecht D, Schoeman J, Donald P, Hartzenberg H (2001) Ventriculoperitoneal shunting in childhood tuberculous meningitis. Br J Neurosurg 15:119–125

    Article  PubMed  CAS  Google Scholar 

  24. Schoeman J, Donald P, Vanzyl L, Keet M, Wait J (1991) Tuberculous hydrocephalus: comparison of different treatments with regard to ICP, ventricular size and clinical outcome. Dev Med Child Neurol 33:396–405

    Article  PubMed  CAS  Google Scholar 

  25. Topczewska-Lach E, Lenkiewicz T, Olanski W, Zaborska A (2005) Quality of life and psychomotor development after surgical treatment of hydrocephalus. Eur J Pediatr Surg 15:2–5

    Article  PubMed  CAS  Google Scholar 

  26. Casey ATH, Kimmings EJ, Kleinlugtebeld AD, Taylor WAS, Harkness WF, Hayward RD (1997) The long-term outlook for hydrocephalus in childhood - A ten-year cohort study of 155 patients. Pediatr Neurosurg 27:63–70

    Article  PubMed  CAS  Google Scholar 

  27. Ding YC, Lai Q, McAllister JP, Canady AI (2011) Impaired motor learning in children with hydrocephalus. Pediatr Neurosurg 34:182–189

    Article  Google Scholar 

  28. Hoppe-Hirsch E, Laroussinie F, Brunet L, Sainte-Rose C, Renier D, Cinalli G, Zerah M, Pierre-Kahn A (1998) Late outcome of the surgical treatment of hydrocephalus. Childs Nerv Syst 14(3):97–99

    Article  PubMed  CAS  Google Scholar 

  29. Kokkonen J, Serlo W, Saukkonen AL, Juolasmaa A (1994) Long-time prognosis for children with shunted hydrocephalus. Childs Nerv Syst 10:384–387

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported by Foundation of Science and Technology Department of Zhejiang Province of China (No. 2010C33090).

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Yuying Children’s Hospital of Wenzhou Medical Collage, Wenzhou, China, 325027

    Jian Lin, Hui Zhou, Nu Zhang, Bo Yin & Hang-song Sheng

Authors
  1. Jian Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hui Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nu Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bo Yin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hang-song Sheng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nu Zhang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lin, J., Zhou, H., Zhang, N. et al. Effects of the implantation of Ommaya reservoir in children with tuberculous meningitis hydrocephalus: a preliminary study. Childs Nerv Syst 28, 1003–1008 (2012). https://doi.org/10.1007/s00381-012-1748-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-012-1748-2

Keywords

Search

Navigation